To link to the entire object, paste this link in email, IM or documentTo embed the entire object, paste this HTML in websiteTo link to this page, paste this link in email, IM or documentTo embed this page, paste this HTML in website

259585.pdf
[27.91 MB]
Link will provide options to open or save document.

File Format:

Adobe Reader

Cbe Li&rarp
of tf?e
Onitoerjsitp of Jftortb Carolina
GEn&otoeli ftp Wbt ^Dialectic
anC
43i)tlantt)ropic &otittit0
N8fch
N/.Z7
Med. \ ib.
This book must not
be taken from the
Library building
LUNC-1SM F 40
THIS BULLETIN WILL BE SENT FREE TO ANY CITIZEN OF THE STATE UPON REQUEST
BULLETIN
OF THE
NORTH CAROLINA STATE BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. G.
Entered as second-class matter at Post Office at Raleigh, N. C... under Act of July 16, ISO!,.
J. Howell Way. M.D., President,Waynesville.
Richard II. Lewis, M.D., Raleigh.
Edw. C. Register, M.D., Charlotte.
J. E. Ashcraft, M.D., Monroe.
David T. Tayloe, M.D., AYashington.
J. L. Ludlow, C.E., Winston-Salem.
W. O. Spencer, M.D., Winston-Salem.
Thomas E. Anderson, M.D.. Statesville.
Chas. O'll. Lalghinghouse, M.D.. Greenville.
W. S. Rankin, M.D., Secretary and Treasurer, Raleigh.
John A. Ferrell, M.D.. Assistant Secretary for Hookworm Disease, Raleigh.
Vol. XXVII. APRIL, 1912. No. 1.
SANITARY SUNDAY EDITION
CO^TEKTS
Sax oaky Sunday : •»
A Growing Chubch and a Sick People 3
The Place of the Physical in Life 7
What the COUNTIES Are Doing 7
Messages from the Front on the Fight Against Smallpox . 8
The McCuixers Case 9
A Word to His Honor the Mayor 1"
The Sixth Commandment and its Interpretation . . . . . 12
Modern Application of the Pakable of the Good Samaritan . 14
Public Health Program for Preachers 15
Waste ir»
Full Text of Supreme Court Decision in M< Ci leers Case . . 23
Controversy Between Mr. B. C. Beckwith and Dr. W. S.
Rankin Oveb the McCullers Case 27-40
O
>
m
2:
o
L*
BOARD OF CONTRIBUTING EDITORS.
1. Governor W. W. KITCHIN, Raleigh, N. C.
2. Hon. A. II. ELLER, Winston-Salem, N. C.
3. Hon. E. W. SIKES, Wake Forest, N. C.
4. Hon. W. C. DOWD. Charlotte, N. C.
5. Mr. CLARENCE TOE. Raleigh, N. C.
6. Mr. ARCHIBALD JOHNSON, Thomasville, N. C.
7. Rev. GEORGE W. LAY, Raleigh, N. C.
s. Dr. HENRY L. SMITH, Davidson, N. C.
9. Dr. FRANCIS P. VENABLE, Chapel Hill, N. C.
10. Dr. W. P. FEW, Durham, N. C.
11. Dr. WILLIAM L. POTEAT, Wake Forest. N. C.
12. Dr. F. L. STEVENS, West Raleigh, N. C.
13. Dr. CYRUS THOMPSON, Jacksonville, N. C.
14. Dr. CHAS. O'H. LAUGHINGHOUSE, Greenville, N. C.
15. Dr. L. B. McBRAYER, Asheville, N. ('.
16. Dr. BENJ. K. HAYS, Oxford, N. C.
17. Dr. EDWARD J. WOOD, Wilmington, N. C.
IS. Dr. WILLIAM DeB. MacNIDER, Chapel Hill, N. C.
19. Dr. H. A. ROYSTER, Raleigh, N. C.
20. Dr. J. L. NICHOLSON, Richlands, N. C.
North Carolina
EDITORIAL
SANITARY SUNDAY—APRIL 28, 1912.
In accordance with an animal custom which we have followed for the
last two years, we are asking the ministers of the gospel to place special
emphasis on the question of community or puhlic health in their sermons
on April 28th.
From time to time, we have called attention to the many phases of
this vital problem which should serve to enlist the cooperation of the
Christian Church. The Bible is full of texts bearing on the problem of
public health. One of the names by which the Master was best known,
the Great Physician, is especially significant, for He was never known
to turn a deaf ear to the physically afflicted. The business world pushes
on, little heeding the fallen by the wayside, as the crowd surged by the
poor blind beggar and bade him hold his peace and trouble not the
Master; but as He heard the plea of Bartimeus, so will His followers,
the organized Christian forces, respond to the inarticulate appeal of
20,000 North Carolinians dying each year from preventable diseases,
and 40,000 of their neighbors needlessly bed-ridden for the entire year
from the same class of diseases.
A GROWING CHURCH AND A SICK PEOPLE.
The Bureau of the Census of the United States Government shows that
during the last fifty years there has been a steady and healthy growth
of the Christian Church, both in number of churches and value of
church property. The figures show that the church has, without a
single intermission, grown more rapidly than the population, and the
seating capacity with one single decennial decline which followed the
Civil "War, has been more rapid than the growth of the population.
The figures compiled from the Census Beport are as follows
:
4 BULLETIN N. C. BOARD OF HEALTH.
population in 1850 to 125 per hundred thousand in 1904. William E.
Kellicott, in his book, "The Social Direction of Human Evolution,"
says about these statistics of prisoners:
"Not all of this increase can be attributed to more rigid enforcement of the
law or raised standards of morality; there is sonic reason for thinking that
whatever change there has been in these respects has tended to have the
opposite effect. We should note, in considering such data as these, that the
penologist generally assumes that of the total number of offenders, actually
only about 10 per cent are in prison at any one time."
In the United States murders and homicides per hundred thousand
of the population have nearly trebled in the last fifteen years. Insanity
increased in the United States from 183 per hundred thousand of the
population in 1880 to 225 per hundred thousand in 1903. We have in
this civilized country, all told, approximately three million defective
people—insane, feeble-minded, blind, deaf, dumb, paupers, juvenile
delinquents, and criminals. That is to say, one person out of every
thirty of our population is defective. Take our country as a whole,
about 5 per cent of the population are at some time in their lives
dependent upon public charity; that is to say, that we have between
four or five million paupers in our country; and it is estimated by
sociologists of National repute that ten million of our population are
below the poverty line; that is, their physical efficiency is under par on
account of deficient food and poor clothing.
Divorce may be considered alongside of these other symptoms of
National diseases, because divorces disintegrate the very unit in the
structure of civilization. In the United States one out of every twelve
marriages results in divorce ; and this country, our blood-bought country
in which we have so much pride, has more divorces than all the rest of
the civilized world. In the State of Washington there is one divorce
in every four marriages ; in Montana one to five ; in Colorado, Texas,
Arkansas, and Indiana one to six; in California and Maine one in
seven; in New Hampshire, Missouri, and Kansas one in eight, and in
the city of San Francisco one in three. From 1867 to 18S6, twenty
years, the population of the United States increased 60 per cent
;
divorces 157 per cent. From 1887 to 1906, the next twenty years, the
population increased 50 per cent; the divorces 160 per cent. For 1905
the following statistics are available:
•United States 67,976 Great Britain and Ireland 821
Germany 11,147 Denmark 540
France ' 10,860 Sweden 448
Austria-Hungary 5,785 Norway 408
Switzerland 1.206 Australia 339
Belgium 901 New Zealand 126
Holland 900 Canada 33
Italy (1904) 859
•Quoted from "Sociology and Modern Social Problems," by Elhvood.
A well-known writer says
:
''Thus we are apparently within measurable distance of a time when, if
present tendencies continue, the family, as a permanent union between hus-band
and wife, lasting until death, shall cease to be. At least, it is safe to
say that in a population where one-half of all marriages will be terminated
BULLETIN ST. C. BOARD OF HEALTH. O
by divorce the social conditions would be no better than those in the Rome of
the decadence. We cannot imagine such a state of affairs without the exist-ence
alongside of it of widespread promiscuity, neglect of childhood, and
general social demoralization."
"What is the explanation of the apparent spiritual advancement coinci-dent
with moral and physical decline ? Ignorance ? Yes, of a kind, but
not the kind due to the lack of growth of educational work as con-ceived
by the teachers of the last thirty years, for the census shows that
there has been a continued decrease of illiteracy, from the time the first
census was taken in regard to illiteracy, in 1880, from 17 illiterates per
hundred population in 1880 to 13 illiterates per hundred in 1890 and
10 illiterates per hundred in 1900. There is a kind of knowledge, how-ever,
that the schools have not taught and that the race is sadly deficient
in, and it is undoubtedly responsible for much of the deterioration of
to-day. That all-important knowledge has to do with the laws of life,
the appreciation of the laws of heredity and of bad environment on the
functions of the human body. Our educational system in the past has
busied itself not too much with the development of the human mind,
but too little with the development of the human body.
Nor can we explain the array of facts above cited on a basis of
economic conditions. Here it is interesting to note that we have statis-tics
showing the growth of total wealth and per capita wealth in the
United States for the last fifty years. But our economic condition
depends not upon per capita wealth, but upon the distribution of wealth.
One man, or a few men, could own the entire wealth of the country
without changing in the least the per capita wealth; but the economic
situation that would result from such concentration of wealth would
profoundly influence the welfare of the race. And yet, with all the
noise the politicians are making about the concentration of wealth,
the United States Government, so far as we can ascertain—and we have
gone to the highest authorities, and a number of them—cannot state on
a basis of facts and figures anything regarding the distribution of
wealth in this country. The absence of such facts reflects upon our
system of government. However, I think we may safely conclude that
the economic situation in the United States has at least not deteriorated
during the last fifty years, and, in all probability, has much improved,
so that the symptoms of National diseases, above cited, would not be
ascribed to our economic conditions.
Communicable diseases, the only kind of diseases that Ave have to con-sider
from a public health viewpoint, depend upon the existence of
some common bond existing between those who become diseased. In
a small community or city, this bond of union exists in the nature of
some of the common utilities, such as schoolhouses, churches, postofficcs,
laundries, swarms of flies, etc. In larger collections of people tile only
bonds of union are customs, habits of thought, and ideals. These throe
things affect large bodies of people, and if the customs are improper,
the habits of thought bad, and their ideals not in accordance witli
natural (which is also divine) laws, then you may expect abnormalities
in the National life. The educational system of our country lias con-fessed
its sin already in the almost universal recognition among our
educational leaders of the importance of the physical in its relation to
6 BULLETIN N. C. BOARD OF HEALTH.
the mental. Medical inspection of schools is being adopted in all pro-gressive
communities, and the laws of hygiene and sanitation are being
taught in the public schools as never before. As this knowledge becomes
more widely disseminated the present race will take better care of itself,
will become more efficient physically, have better homes, think better
thoughts, and will be better morally. Again, let us remember, it takes
a good animal to make a good man.
Still we are lacking in the development of an appreciation of the
most important fact. in its relation to defects of all classes and crimes,
namely, the factor of heredity. The laws of heredity are just as much
laws of divine origin as the ten commandments, and no race can prosper
that disregards them. I give two concrete examples here, quoting from
"Social Direction of Human Evolution," by William E. Kellicott,
typical of the effect of these laws which Darwin had in mind long ago
when he wrote
:
". . . . except in the case of man himself, hardly any one is so ignorant
as to allow his worst animals to breed."
"One of the best known families of this type is the so-called "Jukes' family
of New York State, so carefully investigated by Dugdale. This family is
traced from the five daughters of a lazy and irresponsible fisherman, born
in 1720. In five generations this family numbered about 1.200 persons,
including nearly 200 who married into it. The histories of 540 of these are
well known and about 500 more are partly known. This family history was
easier to follow than are some others because there was very little marriage
with the foreign-born—'a distinctively American family.' Of these 1,200
idle, ignorant, lewd, vicious, pauper, diseased, imbecile, insane, and criminal
specimens of humanity, about 300 died in infancy. Of the remaining 000, 310
were professional paupers in almshouses a total of 2,300 years (at whose
expense?); 440 were physically wrecked by their own diseased wickedness:
more than half of the women were prostitutes; 130 were convicted criminals:
60 were habitual thieves: 7 were murderers. Not one had even a common
school education. Only 20 learned a trade, and 10 of these learned it in State
prison ! They have cost the State over a million and a quarter dollars, and
the cost is still going on. Who pays this bill? What right had an intelligent
and humane society to allow these poor unfortunates to be born into the kind
of lives they had to lead, not by choice, but by the disadvantage of birth?"
•'.... let us finally return to the other side of society and look at a
summarized statement of the Edwards family given by Boies and drawn from
Winship's account of the descendants of Jonathan Edwards. One thousand
three hundred and ninety-four of his descendants were identified in 1000.
of whom 295 were college graduates ; 13 presidents of our greatest colleges
;
55 professors in colleges, besides many principals of other important educa-tional
institutions; 60 physicians, many of whom were eminent; 100 and more
clergymen, missionaries, or theological professors; 75 were officers in the
army and navy ; 60 prominent authors and writers, by whom 135 books of
merit were written and published and 18 important periodicals edited; 33
American States and several foreign countries, and 92 American cities and
many foreign cities, have profited by the beneficent influence of their eminent
activity: 100 and more were lawyers, of whom one was our most eminent pro-fessor
of law: 30 were judges; SO held public offices, of whom 1 was Vice
President of the United States; 3 were United States Senators; several were
governors, members of Congress, f'ramers of State constitutions, mayors of
cities, and ministers to foreign courts; one was president of the Pacific Mail
Steamship Company; 15 railroads, many banks, insurance companies, and
large industrial enterprises have been indebted to their management. Almost
if not every department of social progress and of the public weal has felt
the impulse of this healthy and long-lived family. It is not known that any
one of them was ever convicted of crime."
BULLETIN N. C. BOARD OF HEALTH.
What we need in this country is greater stress on the importance of
the physical and if the churches will devote themselves a little more to
the "here" and a little less to the "hereafter" ; if preachers would give
more attention to the means, and possibly a little less attention to the
end, we believe that the evidence of the racial deterioration above cited,
which casts its shadow on a growing church, would be less noticeable.
THE PLACE OF THE PHYSICAL IN LIFE.
In the creation, according to Moses, the inorganic world, the vegetable
world, the lower animal world, and finally man were created, in the
order given. According to the same inspired writer, in the creation of
man himself, his physical parts were first formed, and to them the higher
mental and spiritual faculties were added. In the creation by evolution,,
the same order, from lower to higher form, takes place—from the worm
of the dust to a place a little lower than the angels. In embryonic or
prenatal development, the same order from the lower to the higher
obtains—the body framework, the heart, the blood vessels, the alimentary
organs, the nervous system, and of the last system, its higher part, the
mind, develops and continues its growth long after the other less highly
organized structures have reached their maturity. It is God's way,
according to both inspiration and nature, to make the physical a prelimi-nary
essential to the spiritual. From a public point of view, which sees
the average human being and not the exception, the truth of Herbert
Spencer's saying, that it takes a good animal to make a good man, is
fully realized.
WHAT THE COUNTIES ARE DOING.
LENOIR COUNTY.
The County Board of Health at their February meeting, under section
9, chapter 62, Public Laws of 1911, enacted several important regulations
for their county.
A regulation requiring the vaccination of all children attending the
public schools was adopted.
A regulation requiring the installation of sanitary privies of the type
suggested by the State Board of Health at all public schools was adopted.
A third progressive and commendable step was the following regula-tion:
"That no general drinking cup or dipper shall hereafter be allowed to be
attached to, maintained, or remain as a part of any public place for supplying
drinking-water within the limits of the county of Lenoir, including especially
all street fountains, pumps, and water-supply places for public schoolhouses
within said county or any city or town thereof."
So far as we know, Lenoir County is the first county in this State ro
take this step.
LEE COUNTY.
The following letter from Dr. J. P. Monroe, the County Superintend-ent
of Health, shows an active interest and definite progress in the health
work of Lee
:
8 BULLETIN N. C. BOARD OF HEALTH.
Db. W. s. k.\.m;i.\, Raleigh, V. C.
Dear Sir:—We held a meeting of rhe Board of Health yesterday instead
of the regular January meeting. It was decided to carry out the State law
relative to smallpox and not undertake the quarantine. The order issued last
year to the school board, to have sanitary privies built at each public school
building, was ordered to be carried out during the summer months. An unani-mous
request was made to the county commissioners that they build a county
home. It was ordered thai the commissioners contribute one-half and Jones-boro
and Sanford the other half of the necessary funds to secure Dr. Ferrell
for two weeks in the spring to give hookworm treatment. I feel sure that the
county commissioners ami the two towns will supply the necessary funds for
this treatment. Will write you as soon as I can get a hearing from them.
Yours fraternally.
(Signed) J. P. Monroe.
CUMBERLAND COUNTY.
The county commissioners have bought a site two and one-half miles
from Fayetteville for a new county home, the plans for which are now
being drawn. The county home will be thoroughly modern in construc-tion,
arrangement, and equipment. It will include suitable quarters for
treating tuberculosis, and will also be provided with wards where the
indigent sick of the county may be. cared for.
HAYWOOD COUNTY.
The County Board of Health, with the approval of the County Board
of Commissioners, have employed Dr. J. B. McCracken, their County
Superintendent of Health, to give two weeks of his entire time this fall
to speaking in different sections of the county on the subject of prevent-able
diseases.
We believe that Haywood is the first county to have taken such action
as this, and we commend her good example to other county boards of
health.
JOHNSTON COUNTY.
The County Board of Health, conjointly with the County Board of
Commissioners at the February meeting of the Board, passed resolutions
requiring the County Superintendent of Health to make quarterly
inspections of all the incorporated towns of the county. During the
inspection the health officer is to visit the schools, examine the sanitary
conditions of the schoolrooms and grounds, make medical inspection of
apparently physically defective children, and to report the results of
these inspections regularly to his County Board of Health. For these
services he is to be paid $4 per diem and 62V2 cents per mile, one way.
This is another important step in the right direction that other
counties can Avell pattern after.
MESSAGES FROM THE FRONT IN THE FIGHT AGAINST SMALLPOX.
Dr. D. A. Dees, County Superintendent of 'Health of Pamlico Count)/,
writes: "The posters sent me concerning smallpox have been thoroughly
distributed throughout the county. A great many people have been
vaccinated—negroes, even, applying for vaccination. I shall do all in
my power to make our present method of handling smallpox a success.
There are no more cases than we had when we had quarantine,
BULLETIN N". C. BOARD OF HEALTH. \)
and not one-half the trouble. Three places in the county have cases,
Oriental, Bayboro, and Vandemere. There has been more voluntary
vaccination than in all the epidemics we have had in former years.
Fortunately, we were able to keep the commissioners from establishing
quarantine. It is only a question of time, in my mind, when North'
Carolina will stay clear of smallpox if we keep the present law, and the
money we have spent in the past will be used for more important pur-poses
than in trying to protect those who will not protect themselves."
Dr. J. E. Malone, County Superintendent of Franklin County, writes:
"Your plan of education in the handling of smallpox is working well.
The people are sending for me to vaccinate them, and that is a good sign.
I have had our smallpox posters put up in different parts of the county
and I have ordered fresh points. The people begin to understand that
we are not going to quarantine, but vaccinate."
Dr. William S. Jordan, County Superintendent of Health of Cumber-land
County, writes: "From the clippings inclosed you will observe
that smallpox is to a great extent occupying the minds of our people
just at this time. They are arranged in the order in which they appeared
in the Fayetteville Observer.
"It is right amusing to note the nature of the comments in regard to
quarantine and realize that in no sense has the critic grasped the mean-ing
of abolishing the quarantine of smallpox in favor of vaccination, or,
rather, the meaning of the law, that by abolishing quarantine general
vaccination can be secured.
"During our present smallpox scare with no quarantine more than
1,500 people have been vaccinated in Fayetteville; whereas if we had
had quarantine I am satisfied there would not have been 200 vaccinated."
Dr. A. ' C. Bethune, County Superintendent of Health- of Moore
County, writes: "In the last thirty days I have had eighteen cases
| smallpox] in this county ; twelve cases near Elsie, three cases near
Pinehurst, and three cases in the neighborhood of Jackson Springs.
"From the three original cases brought into this county from Rocking-ham
I had more than a hundred exposures, but only fifteen new cases,
and these would not have occurred had patients been vaccinated in time.
"We have no quarantine regulations in this county for this disease,
but we are vaccinating a good many. In the last two weeks we have
vaccinated about three hundred people. I have been in the field every
day, and have gone from house to house explaining the object of vacci-nation,
and have met with splendid success. In the part of the county
where Ave have this infection we had an entirely unvaccinated population,
but they are interested and are offering themselves freely for vaccination.
We will likely order vaccination for the school children at an early date,
and in the meantime I am going from school to school and vaccinatinu'
all who offer."
THE McCULLERS CASE.
The McCullers case, recently decided in the Supreme Court of North
Carolina in favor of the plaintiff, Dr. J. J. L. McCullers, and againsl
the Wake County Commissioners, is important from a public health
10 BULLETIN N. C. BOARD OF HEALTH.
standpoint on account of the question of the State's interest and the
State's authority in county health work being seriously involved. The
opinion of the Supreme Court in this case, the position of the county
commissioners, and the bearing of the case upon the public health work
of the State, is published in this issue of The Bulletin. The contro-versy
between Mr. B. C. Beckwith, the County Attorney for Wake
County, who, of course, espouses the cause of the county commissioners,
and the Secretary of the State Board of Health, who defends the Wake
County Board of Health for its position in the McCullers case, and main-tains
the advantages of the control of county health work by nonpartisan
county board of health, is given in full in this Bulletin.
A WORD TO HIS HONOR THE MAYOR.
For His Own Sake, for His City's Health, and for His State's Good Name,
Please Read This: It May Pay You Handsomely.
The mayor of every municipality in North Carolina which has a popu-lation
of 500 or over, according to the 1910 census, is held responsible
by the State laws for the enforcement of chapter 722, Laws of 1909, as
amended by the General Assembly of 1911, which requires the registra-tion
of all deaths occurring in his jurisdiction according to the rules
prescribed under the aforesaid law. Section 5 of this chapter places his
Honor under a penalty of from $10 to $50 for the nonenforcement of
the law aforesaid. We respectfully request the careful reading of chap-ter
722, Laws of 1909, as amended by the General Assembly of 1911,
and especially of the 5th section of the said chapter.
SOMEBODY IN DANGER.
We know that some of the municipalities of North Carolina are not
registering all their deaths. We now have on -file in this office the abso-lute
proof of deaths which have occurred in several registration munici-palities
for which we have received no death certificates. In one munici-pality
we hold as many as ten unregistered deaths against the mayor.
Now, we are not going to name the several towns referred to ; this is
to notify the mayors of these towns that it will be to their interest to
have their local registrar review his work and to file certificates in this
office of deaths that are unregistered and of which the State has not as
yet taken official cognizance. "The thing for each mayor to do is to make
sure that his town or city is not one of those referred to.
Unless death certificates are filed in this office before the first day of
May, 1912, covering the known deaths which we hold and which are
unregistered, we shall appear before the first grand jury meeting in the
county in which these municipalities are located, and ask for indictment
of the mayor who is responsible for the violations of the State registra-tion
law. We are specifically commanded in section 3 of the aforesaid
State law to perform this disagreeable duty; and we shall not fail to
perform our duty because it is disagreeable. We sincerely hope that this
notice will serve as a warning and that the mayors of the registration
BULLETIN N. C. BOARD OF HEALTH. 11
municipalities of this State will have the work of their local registrar
reviewed, and, if unregistered deaths are found, to have death certificates
filled out for them and filed with us before May 1, 1912.
THE IMPORTANCE OF A VITAL STATISTICS LAW.
Do not allow yourself for a single moment to indulge the thought that
the value and the necessity of a vital statistics law cannot he established,
and easily established, with the average jury. Do not conceive the idea,
if you have never given the question of vital statistics any study, that
this law is a mere matter of form or "red tape." It is essential to the
health and the life of North Carolina people. This statement we can
and will make good in the courtroom.
If you would appreciate the importance of this law, ask yourself how
you would go about ascertaining the health of a town or community or
State. Would you write some citizen of the place in which you were
interested, and ask his opinion? Could you expect anything but a
favorable opinion from one whose material advancement depended upon
your favorable opinion in regard to the advantages of buying property
in his city ? What you would do, would be to write to the United States
Bureau of the Census or to your State Board of Health and find out
the average death rate from all causes and for certain diseases through-out
the United States, secure comparative data from the town whose
health conditions you are interested in, and by comparing the two, see
exactly how the health conditions of the town in question compared with
the average. Vital statistics are the means, and the sole means, of detect-ing
the symptoms of a sick community or town. Take them away or
make them inaccurate, and the sanitarian has nothing to guide him
in recognizing disease politic, and certainly he cannot treat that which
he cannot recognize. In short, vital statistics are to public health work
what the symptoms of a disease are to the individual practitioner.
When they are incomplete they give the impression of a healthy town
when a sick town exists, and should be treated, with the ultimate effect
of saving many human lives. Incomplete statistics are misleading; it
is better not to be led at all than to be misled.
Not only do incomplete vital statistics place the mayor under penalty
for violations of this law, and make it impossible to recognize and
improve health conditions in his municipality, that is, to save the lives
of his constituency, but these incomplete statistics endanger the standing
of his State in the estimation of the civilized world. Most civilized
countries, 60 per cent of the United States, including most of the
Northern States and the progressive Western States, take official cogni-zance
of and record the two principal events in the lives of their citi-zens—
birth and death. Nonregistration of births has frequently resulted
in the failure of a child to inherit the property to -which it should have
been heir, in its being placed in industrial plants under age, in its failure
to obtain insurance or the right to exercise its suffrage. Nonregistration
of deaths has not only a profound bearing on the general welfare of
people from a sanitary point of view, but is important from a legal
standpoint, frequently making unnecessary exhumations, and exhuma-tions
which in most cases are valueless as evidence on account of
advanced decomposition of the deceased.
12 BULLETIN N. C. BOARD OF HEALTH.
The United States Census has examined the registration of deaths in
North Carolina and has satisfied itself that the registration law of North
Carolina is so incompletely enforced in about twenty of the municipali-ties
of the State that the figures of North Carolina are misleading and
cannot be accepted by the United States Government. This means, of
course, that the outside world will not accept the registration statistics
from North Carolina when our own National Government cannot accept
them. . . .
The mayor who is not requiring a complete registration of deaths in
his town or city is in this way denying a proper standing to his State
among the civilized countries of the world.
Now, his Honor can enforce this law. If he thinks he can't, let him
read it ; and, then, if he thinks he can't, let him recall that it is being
enforced for 60 per cent of the population of the United States; that
its enforcement has proved to be practicable. And, in conclusion, let me
assure any mayor who doubts that this law can be enforced, that the
State Health Officer, although a comparative stranger in his town, can,
through an examination of the newspaper files of his town or city paper,
through interviews with hardware dealers who sell coffins, doctors, ceme-tery
keepers, and preachers, easily discover unregistered deaths if the
law has not been properly enforced. And if Ave can do it, his Honor
certainly can do it.
A last word : Unless you are positively sure that your city is not one
of those against which we hold the proof of unregistered deaths, which
places you under a penalty of from $10 to $50 for each unregistered
death, we respectfully request that you confer with your local registrar,
the undertakers, the physicians of your acquaintance, and make sure
that this law is enforced and that there is no danger of the grand jury
hearing charges against you at the next term of your county court.
"We issue this warning and make this request to save both yourself
and us disagreeable court, proceedings.
THE SIXTH COMMANDMENT AND ITS INTERPRETATION.
Hexry Louis Smith, Ph.D., M.D., President Davidson College; Contributing Editor of The Bulletin.
Of all the history-making creeds and confessions of the religious
world, probably none was compiled with such exceeding care, or has so
profoundly influenced the history and development of the English-speak-ing
races as the Standards formulated by the Westminster Assembly of
Divines about 265 years ago. These Standards embodied in clear and
condensed form the Puritan-Presbyterian interpretation of the Scrip-tures
as a systematic whole, touching life and doctrine at every point.
The great Assembly spent five and a half years on its work, and held
over 1,100 sittings. The immortal Shorter Catechism of this Assembly
condenses the whole into a few pages, giving an epitome of the whole
Calvinistic system.
The exposition of the sixth commandment therein contained employs
less than two score words, yet it sweeps the whole gamut of modern sani-
BULLETIN N. C. BOARD OF HEALTH. 13
tation, community uplift, organized cleanliness, medical care of neglected
children, and preventive medicine in all its varied aspects. After the
statement that the sixth commandment is, "Thou shalt not kill," follow
two questions, constituting the 68th and 69th of the Catechism. The
68th, "What is required in the sixth commandment?" Answer: "The
sixth commandment requireth all lawful endeavors to preserve our own
life and the life of others." 69 : "What is forbidden in the sixth com-mandment?"
Answer: "The sixth commandment forbiddeth the taking
away of our own life, or the life of our neighbor unjustly, or wliatsoever
tendeth thereunto."
When we remember that this interpretation of the sixth commandment
was wrought out nearly three centuries ago, before the modern science
of sanitation and preventive medicine was heard of, we are astonished
at its perspicacity, its breadth, and its up-to-dateness. We stand amazed
that the Church has thundered against the violent taking away of human
life, yet has so rarely recognized that the divine obligation imposed by
the commandment extends to the conserving of human life by warding
off all preventable diseases, and that the divine imperative forbids all
practices, modes of living, and methods of conducting business, that
needlessly endanger the health of those thus employed.
To the philosophic mind, our bondage to the gross, the palpable, and
the spectacular is almost inconceivable. When a fair-haired little girl
is ruthlessly murdered with an axe or a bludgeon, the whole Nation
grows hysterical in a frenzy of indignation ; yet, perhaps, on that very
day families are moving all their earthly belongings into tenement,
houses made vacant by tuberculosis, and our communities watch the pro-cession
to the graveyard begin again without a word of protest.
When a tenement house catches fire, and in spite of the valor of the
firemen and the sympathy of thousands of spectators, some of its inmates
perish in the flames for lack of fire-escapes, the whole land grows
righteously indignant, and the owner of the building is probably prose-cuted
for murder. Yet the general public allows the filth and unsanitary
condition of such a building to doom a large percentage of its inmates
to death every year without a lawsuit or a word of protest.
If a dweller in one of our cities kept a ferocious wolf on his premises,
and his captive, through the carelessness of its owner, should escape and
tear a citizen to pieces on the public highway, the whole city would be
in a white heat of righteous indignation. It endures, however, without
realization or protest, the breeding of flies and mosquitoes in countless
millions on premises whose owner can easily abolish such breeding places
if he desires, but is too lazy or careless or avaricious to do so. Yet it is
undoubtedly true that these insects destroy the lives of more people in
any one State, in one year, than all the wild beasts and mad dogs of the
United States have destroyed since the settlement of our country.
Our greatest Teacher, twice himself, taught us how to interpret and
apply these marvelous ten Words of the Law. FolloAving His example,
we must believe that the prevention of diseases is as clearly enjoined by
the sixth commandment as the prevention of actual murder, and thus
every such effort has a religious sanction and is a religious duty. Minis-ters,
therefore, can and should pi*each on the whole meaning of the sixth
commandment, as on the whole meaning of the other nine, enjoining the
care of our lives and the lives of others as a religious duty.
14 BULLETIN IT. C. BOARD OF HEALTH.
THE MODERN APPLICATION OF THE PARABLE OF THE
GOOD SAMARITAN.
\V. P. Few, Ph.D., President of Trinity College; Contributing Editor of The Bulletin.
I do not know that a text could be found better suited for a sermon on
Sanitary Sunday than the parable of the Good Samaritan, enforcing as
it does so powerfully and beautifully the human duty of neighborliness
and care for the sick.
_
Modern civilization rises or falls just in proportion as it embodies m
itself the principles included in what the New Testament calls the King-dom
of God, that is, that reign of ultimate truth which Jesus Christ
came to set up in the lives and characters of men.
While this truth may be called ultimate in its finality, it is not given
to us in the shape of a formulated philosophy of life. It is germinal in
its character. It is to be interpreted and applied to all phases of our
life and conduct. This parable, for example, has nothing to say specifi-cally
about preventive medicine, sanitation, or hospitals; still it holds
in solution the whole doctrine of care for the sick and needy. The ideas
we are left to work out for ourselves ; that is the field of modern science
and that has been a chief discipline of the race. But it does lay upon us
the Christian duty of using the best wisdom of this generation and of
all generations not ony in tending the sick, but especially in making the
conditions of life wholesome and uplifting, and so preventing sickness.
If it is a duty to help the sick, it is an even higher duty to_ prevent
sickness so far as that lies within the power of a well-ordered civilization.
If we rely on Providence to take care of us when we ourselves do not use
all the means within our reach, we are merely sinning against the light.
Ideas, as opposed to germinal truth, are the outgrowth of advancing
civilization, and new ideas are constantly needed when changed condi-tions
arise. Hence the necessity for constant progress, else there must
be sure decay. The crowded conditions of modern life in cities and
densely populated districts make necessary new methods for preventing
the spread of disease; otherwise the health and welfare of the whole
people are placed in jeopardy. So comes about the duty for communities
and States not merely to care for the sick individual, but to create condi-tions
that will make for the health and happiness of the whole people.
And this, I think, is doing nothing more than giving a wide application
to the parable of the Good Samaritan.
To lay properly the physical foundations of life is a stupendous task
to which the race had scarcely begun to set itself. The marvelous
achievements in material progress and widespread physical well-being
within the past fifty years have made it possible for large numbers to live
comfortably and even sumptuously with the body. The attainments of
the recent past are, no doubt, but a faint foreshadowing of whatis to
follow in the long and upward march of the human race. And in all
the efforts of religion and education and civilization to keep and trans-mit
the precious heritage of humanity, one of their first tasks is this
conservation, strengthening, and sweetening of human life itself.
"He hath anointed me to preach the gospel to the poor; he hath sent
me to heal the broken-hearted; to preach deliverance to the captives, and
BULLETIN N. C. BOAKD OF HEALTH. 15
recovering of sight to the blind ; to set at liberty them that are bruised."
In these words from the ancient prophet, Jesus Christ at the outset of
His earthly career announced His mission to free and expand all the
powers and all the capacities of our human nature. It is a prophecy of
a completely redeemed humanity, and the splendid vision will become a
reality when the bodies, the minds, and the characters of men are cared
for as they should be, on a vast and universal scale.
PUBLIC HEALTH PROGRAM FOR PREACHERS.
William Louis Poteat, LL.D., President Wake Forest College; Contributing1 Editor of The. Bulletin.
The preachers of North Carolina are so intelligent a body of men and
are so alert in their consecrated service to the community that it would
seem almost an impertinence to make suggestions to them about their
opportunities respecting the public health. I venture, however, upon
the request of the Secretary of the Board of Health, to offer for their
consideration the following program of activities
:
I. Form and inform the local public opinion by at least one sermon
on public health. Texts : "He wrent about doing good." Acts x :38. "All
they that had any sick with divers diseases brought them unto him;
and he laid his hands on every one of them and healed them." Luke
iv :40.
Two leading ideas
:
1. The distinctively practical aim of Jesus' teaching and work.
2. The large part of His public ministry devoted to curing the sick.
II. Help in finding practical expression of the informed public opin-ion
on public health
:
1. Cooperate with local physicians. Attend meetings of the county
medical society.
2. Distribute, Avith the same motive and fidelity as in the case of
religious tracts, the bulletins and other publications of the State Board
of Health.
3. Organize clean-up leagues and sanitary clubs, enlisting the interest
of the women of the community.
WASTE. 1
fBy Cyrus Thompson, M.D., Jacksonville, N. C.
If the art of living is the finest of all the fine arts—and who that
dreams of a perfect life shall doubt it?—then the saddest thing in life
is man's slowness in learning to live it. The world is so beautiful, so
beneficent, so abundant. The order of nature is so frugal and so con-
*Annual oration delivered before the Seaboard Medical Association of Virginia and North Caro-lina,
at Newport News, Va., December 5, 1911, and first published in The Virginia Medical Semi-
Monthly.
tDr. Thompson is a Contributing Editor of The Bulletin.
16 BULLETIN N. C. BOARD OF HEALTH.
servative. In the stars of the firmament, there is no lost motion ; no
planet swerves from its helpful path; there is no dissipation of energy
but is conserved in some useful form. If human economy is negligent,
destructive, and wasteful, the divine order is constructive and saving.
Out of the void and darkness, the spirit of God created all that is, pre-serves
it all, and destroys nothing. Out of the abundance of man's her-itage,
over which he holds rightful dominion, behold the waste of life,
the waste of opportunity, the stupendous waste of material
!
Just one old Book contains the wisdom of the ages—written by the
best of their times about the best when at their best. As a scheme of
life the world's literature has nothing comparable to it. It makes record
of the one perfect life, the one universal man, the measure of all men.
In Palestine one afternoon, this Galilean had been teaching a vast
multitude. "When the day began to wear away, then came the twelve
and said unto him, 'Send the multitude away, that they may go into the
towns and country round about, and lodge and get victuals; for we are
in a desert place.' But he said unto them, 'Give ye them to eat.' And
they said, 'We have no more but five loaves and two fishes, except we
should go and buy meat for all this people.' For they were about five
thousand men. And he said to his disciples, 'Make them sit down.'
Then he took the five loaves and tw^o fishe3, and looking up to heaven
he blessed and brake and gave to the disciples to set before the multi-tude.
And they did eat and were all filled." "When they were filled"
—
with food and no less -with wonder—when the multitude and the disciples
of the Master were satisfied and ready to go away, then came to his
disciples this command out of the carefulnesss of God, "Gather up the
fragments that remain, that nothing be lost." A desert place, to be
sure—a multitude to be fed, only five loaves and two fishes ; but the Lord
of Life, the master of the feast, the divine economy of saving, and the
fragments more than they had at the beginning
!
With the savage man, all is waste ; as civilization advances, something
is saved, though much is lost.
In a material way, we are saving much. The cotton of the South not
long ago was valuable only for the lint, but now a very considerable
part of the value of the crop is contained in the seed. Thirty years ago,
a seedless lint seemed desirable ; to-day the cotton-grower would almost
welcome a lintless seed. Olives do not grow in the cotton belt, nor cows
and hogs on cotton stalks; but from cotton seed we get lard made in
Chicago, butter churned in Indiana, and olive oil pressed in sunny Italy.
Petroleum gives us everything from axle-grease for an ox-cart to gaso-line
for. an aeroplane; and the profits of the Standard Oil Company are
largely made from the waste of twenty-five years ago. Armour has
learned the saving principle of the whole hog or none; and he puts on
the market everything from the ham to the internal secretion of the
suprarenal gland. It used to be a problem with our sawmills what to
do with the sawdust. Invention found a way to throw it into the furnace
for fuel, and later invention converts it into vood alcohol. On farm
and in factory, improved implements, methods, and machinery make
impossible and ridiculous the slow and wasteful methods of other days.
Vast areas of waste lands we are reclaiming by drainage, and by irriga-tion
we are forcing the desert places to blossom like the rose. The stage-
BULLETIN N. C. BOARD OF HEALTH.
coach is a memory, and railroads are everywhere ; and the wastefulness
of bad country roads is preached at every turn by the makers of auto-mobiles
and gasoline. The Avaste power of turbulent waters is converted
into productive energy. Steam and electricity, the telegraph and tele-phone,
are crowding the world together and wiping out time and dis-tance
; and still, finding it too far withal to steam around Cape Horn,
we are spending our millions to save time, and cut across at Panama.
And in a social way, we are becoming conscious of our wastefulness,
and are turning our minds to the principles that underlie conservation.
I believe that I am right when I say that all social waste is due to the
assertion of individual rights, and all social conservation is founded
upon a denial of them. And I believe that the best government for any
man is that which is best suited to develop the best possibilities that are
in him. The form of government, in other words, must be determined
by the matter of development.
All government is a denial of natural rights and the substitution of
duties for the good of the individual in the common good. The fullest
exercise of natural rights is found in a state of savagery ; the highest con-servation
of rights is found in a state of civilization—in that civilization
which makes fullest denial of natural rights for the well-being of society.
The State exists for the individual, and the individual must exist and
be fitted to exist for the State. Xo personal right can stand in the way
of the individual and social good. The doctrine of rights must yield to
the doctrine of duty; in the higher civilization, the sense of selfishness
must give place to the sense of service.
The law of eminent domain holds true not only in lands and material
things; it is operative as well over men. The State may tax for the
preservation of order and compel for the public service. It may fine
and imprison for crime; for the safety of society, it may take away all
rights for a time or a lifetime; nay, it may take even life itself when
the individual so misuses his rights that his death, better than his life,
subserves the public good.
Preventive medicine, than which there is no finer fruit of civilization,
is founded upon a denial of rights. Compulsory vaccination is primarily
for the safety of the individual, but mainly for public protection. Quar-antine
against acute contagious and communicable diseases is prevention
of waste through denial of personal rights. We may not allow a man to
exercise a right when he exercises it to his own hurt and to the injury of
his neighbors. The right is taken from him for his own and the public
good, so to conserve best his best rights in the health of his community.
These principles we are steadily educating men to appreciate, and
when we come to the full appreciation of the divine economy of service
and saving, pestilence will not walk in darkness, nor destruction waste
at noonday.
A dairyman's cows are his own, to be sure; but he may not sell inf<
milk to waste the health and life of his neighbors' children.
A butcher's meat is his own; but, if unfit for human food, he may not
offer it in the market-places.
A patent nostrum is its maker's own; but let him warn the purchaser
of its narcotic content.
18 BULLETIN N. C. BOARD OF HEALTH.
A manufacturer's money is his own; but he may not spend it for the
cheaper labor of the undeveloped child, or require of a man for a day's
labor toil beyond a definite number of hours.
A man's child is his own ; but he may not waste its growth and health
and life in hazardous labors.
A man may not waste his own child nor his neighbor's child, nor
claim any right of person or property that hinders the aggregate develop-ment
and safety of his community.
On every hand out of the mouths of frauds, ignorance, and politicians,
we hear enough of the rights of men; let us hear more rather of their
duties. We have had enough of waste; it is time we had more of con-servation.
To love our neighbor as ourself is but to see ourself in our
neighbor and to find our safety everlastingly involved in his welfare.
From rights, then, to duties ; so leads the way from waste to permanent
wealth and happiness.
Think for a moment of the stupendous waste in an uneducated and
untrained child, the countless untrained, undeveloped, uneducated chil-dren
of the past. You desire wealth, but intrinsic value resides only in
man; the value of things is derived from man; and the greater or less
value of things is dependent upon the character, the quality of man. A
lively consciousness of this fact is the motive of all progress in education.
Our system of public education is founded upon a denial of rights and
a material consciousness of duties—a denial of the right of the child to
himself, of the right of the parent to his child, of the right of even the
childless man to so much of his money as may be necessary for the
child's education. To conserve, to construct, this is the mark and work
of civilization ; to tear down, to hinder, let that be of the past : it is
diabolical. To build, to prevent waste, this embodies the whole duty of
civilized man. The State is endeavoring to build for the sake of the
individual and itself, and the individual must not be permitted to hinder
or destroy, not even for himself. The State is fulfilling its duty to the
individual, and the individual must be fitted to fulfil his duty to the State.
To prevent waste, therefore, we have everywhere our common schools,
our graded schools, our colleges and universities; our technical schools
for the education of men and our normals for the training of women.
For the same reason we shall come everywhere to a system of compulsory
education. Kecognizing already the defects and consequent waste of our
methods, we are coming even now to the study of exceptional and nervous
children and to the medical inspection of school children in general.
To prevent waste, the State, the churches, and fraternal orders estab-lish
and maintain orphanages. These are not mere charities, not matters
of sentiment only ; they are makers of men and women—they make them,
alas ! far better than the average home
!
To prevent waste, we teach the deaf and dumb and the blind, and
make them self-sustaining members of society.
To prevent waste, we care for the insane and the epileptic, and restore
many of these unfortunates to happy and useful life.
To prevent waste, gathering up hitherto neglected fragments, the
State of North Carolina leads among Southern States in the establish-ment
of a school for the teaching of the feeble-minded. The motive
originated in this society, and stands as one of its glories forever. The
BULLETIN N. C. BOARD OF HEALTH. 19
Commonwealth of Virginia is urged to follow in this constructive work;
and Virginia cannot lag behind.
To prevent waste, everywhere there is better care of the criminal
classes. The old misanthropy did not seek to reform and save ; the old
misanthropy imprisoned in noisome jails without hope of health or
reformation, at the offender's cost and wretchedness. No prouder name
stands in English history than the name of John Howard, the humane
country gentleman, high sheriff of Bedfordshire, the father of modern
prison reform. Begun in sentiments of humanity, the new philanthropy
leads the State to take account of the offender and forces the offender to
take account of the State. We punish the criminal not for the sole pur-pose
of punishing, but for the protection and progress of society, to deter
others from the commission of crime and to reform or improve the
offender and send him home a useful member of society. If we deprive
him of liberty and his rights, it is to make of him a better citizen. We
work him and care for him ; we feed him, clothe and shelter him ; we make
him profitable to himself and useful to the State even against his will.
To prevent waste, we have juvenile courts that consider the defects
and possibilities of the criminal ; and we build reformatories for young
criminals, lest the hope of reformation to useful life be lost by associ-ation
with the irretrievably bad.
To prevent waste, the physician has ceased to be the mere giver of
drugs to them that are sick ; he is become the peripatetic teacher of sani-tation
and hygiene, the guardian of individual and public, the apostle
of the gospel of health. Having fought against death at close quarters
and failed, he warns all men everywhere to fortify against his approach.
And so he adds to the years of human life. If he carries no more of us
beyond the limit of three score years and ten, he leads more lives more
nearly to this limit. Oh ! the waste of life in its prime, the slaughter
of the innocents from mothers' arms, the untimely tears of broken hearts,
before the physician glimpsed the fulness of his mission and began to
rouse the State to the duty of preventive medicine! You've seen the
tumorous scars, in every city, hamlet, and churchyard, that made pre-maturely
leprous the beautiful face of mother earth.
Not that our work is yet fully comprehended or perfected ; but this
one thing we do, forgetting the things that are behind, we press forward,
proud that on stepping-stones of our dead selves we are rising with better
conscience to higher things.
To prevent waste, the manufacturer begins to look after the sanitation
of premises and the health of his operatives. He finds that he can save
life and time and money.
To prevent waste, great insurance corporations are organizing health
departments, issuing health bulletins, and teaching their policyholders
and the public how to live.
And to prevent the waste of war, this relic of barbarism, this verity of
hell—the dream of poet and seer through centuries from Isaiah to the
latest soul that sang in sight of things—to beat our swords into plough-sliares
and our spears into pruning-hooks—the greater nations of the
earth now seek to adjust their disputes by arbitration. May our young
Nation lead the world in this joyous laugh in the face of Death! Oh,
it will come some time, and nations will learn war no more ! Did you
20 BULLETIN N. C. BOAKD OF HEALTH.
ask when? I know not the day; but when man is wise enough to exer-cise
his duty to his fellow as he would now assert his rights in his face,
we shall not be far from the
"One far-off divine event,
Toward which the whole creation moves."
For the world, despite all its evil and waste, is growing better; but
from wild grapes to grapes is a long way, a slow and halting evolution.
But there is more of high ideal and noble purpose in the world than
ever before; knowledge is being diffused as never before, and we are
growing more humane. But if we are on the Appian way, in sight of
the Three Taverns, let us thank God, take courage, and go on : we are
not yet in Rome.
For with all our diffusion of knowledge and increase of humane senti-ment,
with all that we write on our ledger as profit, is there not some-what
that we must set down as loss? "Reaching out for more things
that are good, are we holding fast to the best things that we had?" The
fear of hell may be the hangman's whip to hold the wretch in order ; but
the fear of hell, the fear of punishment, is a necessary adjunct of govern-ment.
The soul that sinneth, it shall die : let that law stand ! For the
wretch, the wrong, the wrong in moral fiber, punishment must be swift
and sure. But on every hand, crime goes unpunished and murder is
unavenged; mobs lynch and set the law at naught. In one turbulent
Commonwealth, even the Governor, the Chief Executive and embodi-ment
of law, condoned a lynching and expressed his willingness to have
resigned his office and led the mob in his own State.
We are losing the fear of punishment both here and hereafter. In
some serious sense, society is letting the sentiment of humanity run pre-maturely
to seed. Our sympathy with the criminal living makes us for-getful
of the murdered dead ; juries listen to sham pleas of insanity, and
courts seriously ponder over the violence of brainstorms. We are too
humane to convict on circumstantial evidence, the only evidence without
possible motive to lie. To withhold lawful punishment from this brood
is to expose the innocent and endanger society; to punish with certainty
is to protect society, lessen insanity and cool the heads of the violent.
To be commended are the courts of Virginia : Beattie said at last that
circumstances had not lied on him; and McCue's insanity did not lessen
his crime or the consequence of it.
So with all our increase of knowledge and growth of humane senti-ment,
our utilization of natural resources and prevention of material
waste, our marvelous National progress, the thoughtful man cannot fail
to inquire if we are building character, making men and women, as well
as we builded in former days. After all, are we not tithing mint and
anise and cummin and forgetting the weightier matters of the law? Are
we as law-abiding as we used to be ; have we the old-time reverence for
sacred things; do we reverence God and the State as our conscience, and
our conscience as the State and God ? By the assertion of rights, are we
not following the way of the prodigal who spent his substance in riotous
living and would fain, at last, have filled his belly with the husks which
the swine did eat ?
BULLETIN N. C. BOARD OF HEALTH. 21
If my son have not respect for my authority and the authority of the
State ; if he reverence not God and holy things ; if he have not faith and
hope and love abiding in him ; if he have not respect for the rights of
others and respect for himself; if he have not character; no wealth or
knowledge of his can tell me that he is not a dangerous derelict without
anchor, and I shall know that he is the heaviness of his father.
I am not preaching you a sermon—I am not cut out for that—hut
whatever of good there is in me comes, I know, from that mature senti-ment
which, when the Sabbath dawns for man's rest, says "Come, let us
go up unto the house of the Lord" ; and, when I have entered, "The Lord
is in his holy temple ; let all the earth keep silence before him !"
Rights and not duties, selfishness and not service—that all men are
created free and equal, that every man is born an uncrowned king—here
is our leakage ; and we go to wreck upon the rock that all just powers of
government are derived from the consent of the governed. It is not true.
Our wilder western commonwealths are eating and offering us the tooth-some
apple of the initiative, the referendum and the recall, even of
judges. For authority, law, order, under which alone abiding progress
is possible, they would substitute the shifting whim of the multitude
;
for obedience and stability they offer us emotion ; for progress, the mere
turbulence of change. In the midst of it all, one feels like crying out
—
"Ah, God, for a man with heart, head, hand.
Like some of the simple great ones gone
Forever and ever by;
One still strong man in a blatant land,
Whatever they call him—what care I?
Aristocrat, democrat, autocrat—one
Who can rule and dare not lie
!"
That all governments derive their just powers from the consent of the
governed—it is not true. But this is time, that even a king must be a
king, not for himself, but for his subjects. Until your uncrowned kings
are developed to comprehend this in themselves, the just power of govern-ment,
even for the sake of the development and safety of your uncrowned
king himself, is founded in the duty which the greater man owes to the
less. We governed Cuba till she was capable of self-government. We
shall govern the Philippines till they are capable of self-government ; it
is our duty to them, and we do not ask their consent. We govern and
care for the disfranchised negro in the South; the wiser of their race
know that it is best. It is a matter of duty, not a question of consent.
One thing more. Whether there be startling political fads and graft
in places low and high; maudlin sentiment for the criminal and slack
enforcement of law; if we grow pessimistic and deplore the decadence of
morals on every hand; if the moral stand aghast at the abundant grist
of divorce mills; know that these things originate in one common source,
the most appalling source of social waste, the increasing laxity of family
government. This is the one most baleful instance of assertion of rights
and negation of duties.
It used to be said that the parent controlled the child; it is now a
common saying that the child controls the parent. That the parent does
not control the child is too grievously true. Parental authority in no
22 BULLETIN N. C. BOARD OF HEALTH.
sense depends upon the consent of the governed. It is inherent in parent-hood;
it is a duty which the parent has no right to disregard, whether
for himself, for his child, or the State. For the family is the indispen-sable
social unit. The purpose of the family is the training of children
to orderly life and citizenship. More and more the family is failing of
its purpose. I must train my child in the way he should go for the
child's sake and for society's sake. It is not a work which I have a
right to do or not to do : it is my inalienable duty to him, to the State,
and to God. I may not relinquish my work any more than the
Creator of all things may abdicate His throne upon the circle of the
heavens. So only can come among men the doing of justice and judg-ment.
The Puritan may have been unduly austere, but the Puritan
made men and women. To spare the rod even and so spoil the child,
what is it but to take out of my child the best that is in him along with
all his best possibilities? I, his king, will have robbed my subject and
wasted the substance of the State.
Patriot and demagogue rant about rights of local self-government
let them descant less upon the beauties of it to the thoughtless, unbridled
multitude; but rather, as fathers, let them teach it to their children
—
teach them obedience to divinely constituted authority and obedience to
self. For "he that ruleth his spirit is better than he that taketh a city."
So may crime be lessened and more surely punished ; so may juries look
up to God and care well for the State ; these new mad-storms of reckless
brains be lulled ere they rise ; the company of the insane will grow
smaller, and the number of hysteric women and psychasthenic men will
grow less.
In the building of character, the right attitude of the soul of man, a
work of early years, nothing can take the place of the family. The
schools are only supplementary. And I pray you, O schoolmaster, teach
my child both obedience and books if you can ; but if you can teach him
no books, teach him obedience to you and control of himself—teach him
this form of local self-government, this most vital, embryonic form of
democracy.
It is said that "when the court chaplain of Frederick the Great was
asked by that gruff monarch for a concise summary of the argument in
support of the truths of Scripture, he instantly replied, with a force to
which nothing could be added : 'The Jews, your Majesty, the Jews !' "
a people enduring, law-abiding, not much given to crime.
"And the Lord said, Shall I withhold from Abraham that thing Avhich
I do, seeing that Abraham shall surely become a great and mighty nation,
and all the nations of the earth shall be blessed in him? For I know him,
that he will command his children and his household after him, and they
shall keep the ways of the Lord, to do justice and judgment, that the
Lord may bring upon Abraham that thing which he hath spoken of him."
It would come in no other way; not even the Lord could bring it any
other way
!
Therefore, whoso shall rouse the heads of American families to resume
their divinely rightful sway, to discharge to their children, the State,
and to God their inalienable duty, he shall preserve our rights and pre-vent
the waste of the Nation.
BULLETIN N. C. BOARD OF HEALTH. 23
*FULL TEXT OF OPINION IN THE McCULLERS CASE.
In view of the fact that the opinion of the Supreme Court in the mat-ter
of Dr. J. J. L. McCullers v. "Wake County Commissioners affects the
entire State, The Times is printing the opinion in full to-day:
No. 217—Wake.
In the Supreme Court of North Carolina,
February Term, 1912.
J. J. L. McCULLERS, APPELLANT, v. THE BOARD OF COMMISSIONERS
OF WAKE COUNTY, N. C.
This is a proceeding for mandamus to compel the defendant board to admit
plaintiff to the office of superintendent of health of Wake County, and to
compel the said board to audit his accounts for services.
The cause was heard by his Honor. Judge Peebles, in the Superior Court of
Wake County on December 1, 1911, and judgment rendered denying the relief
prayed and dismissing the proceedings.
From the said judgment plaintiff appealed.
Aycock & Winston and Bart M. Gatliiu/ for plaintiff
B. C. Becktcith and R. N. Simms for defendant.
Brown. J. The plaintiff derives his title to the office of superintendent of
health of Wake County by appointment of the secretary of the State Board of
Health, under chapter (32, sec. 9, Public Laws of 1911, which provides that if
the county board of health of any county shall fail to elect a county superin-tendent
of health within two calendar months of the time fixed by the statute
when such election shall take place, the said secretary of the State board
shall appoint.
The defendant board of commissioners passed a resolution undertaking to
appoint a superintendent of health and to fix his salary. In consequence of
such conflict between the two boards and the failure to fix his compensation,
the plaintiff appeared before the board of health at its next meeting and
declined to qualify as superintendent of health for Wake County. The board
of health having failed to elect a superintendent for more than two calendar
months, the secretary of the State board, W. S. Rankin, on July 17, 1911,
appointed plaintiff the superintendent of health and quarantine officer for
Wake County, and fixed his fees and compensation, claiming to have done so in
accordance with sections 9 and 16 of said act. The plaintiff qualified as such
and the defendant board declined to recognize him and to pass on. audit and
approve his bills for fees as required by section 9. His Honor found the facts
as stated in sections 1 to 8, inclusive, of the complaint to be true, but it is
unnecessary to state them more fully.
1. It is contended that the contingency had not arisen when the secretary
could lawfully appoint. The statute requires the board of health to meet and
elect on the second Monday in May, 1911. and thereafter on the second Monday
of January in the odd years of the calendar. A majority of the board of
health voted for plaintiff, but he refused to qualify. It was the duty of said
board to at once elect another person. This it failed to do. so that the office
remained vacant for more than two months up to the time the State secretary
made the appointment. We think the true intent and meaning of the statute
is to give such appointment to the State secretary when the board of health
for any reason permits the office to remain vacant for two calendar months
trmn the date fixed by the statute, in this case the second .Monday in .May.
The public iuterest requires that this particular office shall have an incum-bent
to discharge its duties, and the evident intention of the General Assembly
was to prevent the office being unfilled for a longer period than the time named.
We think the learned counsel for the defendants place a too restricted con-
*Raleigh Evening Times, February 22, 1912.
24 • BULLETIN N. C. BOARD OF HEALTH.
struction upon the meaning and purport of the words, "shall fail to elect," as
used in the statute. We think the General Assembly meant the choosing and
induction into office of a superintendent of health within the two calendar
months. State v. Wilroy, 10 Ire., 329. If this were not so, then a hostile
board of health could keep the office vacant by electing a person who would
not qualify, and the purpose of the General Assembly be entirely defeated.
2. But the real controversy in this case, which has been argued with much
force by counsel on both sides, is the constitutionality of section 9 of the act.
The power of the secretary of the State board to make the appointment is
conferred by said section, and if it is void in toto, then it is contended that
plaintiffs title to the office fails. The learned judge of the Superior Court
rook this view and in his judgment expressed it in these words:
"Article 14, sec. 7, of State Constitution, forbids the holding of two offices
by one man at the same time. If the act had provided that D. T. Johnson,
.lames I. Johnson, and Z. V. Judd should constitute the board of health for
Wake County, their acceptance of said office would have rendered vacant the
office of chairman of the board of county commissioners, office of mayor of
Raleigh, and office of superintendent of public schools for Wake County. The
General Assembly seems to have linked the office of superintendent of the
board of health for Wake County with the other three offices and made them
inseparable, and for that reason, I think and hold that section 9 of Public Laws
of 1911, chapter G2, is unconstitutional and void."
It appears that the persons named above are respectively chairman of the
board of commissioners of Wake County, mayor of Raleigh, and county super-intendent
of schools for Wake County. Chapter 62, Laws of 1911, appears to
be a comprehensive revisal of all preceding laws. It covers the entire subject
of public health, both State and county. It first provides for the establish-ment
of a North Carolina Board of Health, which is to be made up by the
election by the Medical Society of North Carolina of four members, and by
appointment of the Governor of five. Section 9 constitutes the county board
of health of the chairman of the board of commissioners, the mayor of the
county town, and when there is no mayor, the clerk of the Superior Court, the
county superintendent of schools, together with two physicians to be elected
by those three public officials.
We are unable to concur in the conclusion that the statute is violative of
Article XIV, sec. 7, of our State Constitution. It is not a case where one
person holds two offices at the same time, but rather the case where the duties
of a member of the county board of health are to be performed ex officio by
the chairman of the board of commissioners, the mayor, and the superintendent
of schools-. These duties cannot be discharged by the individuals named in
his Honor's judgment any longer than during the period they hold the offices
of chairman, mayor and superintendent. The right to discharge such duties
is not conferred upon them as individuals, but is a part of the duties of the one
office already held by each.
The case of Barnhill v. Thompson, 122 N. C, 493, does not sustain the con-tention
of the defendants. The facts in that case show that the board of edu-cation
of Bladen County was elected by the board of commissioners of said
county, the clerk of the Superior Court and the register of deeds, under the
existing law, sitting with them. This body elected the defendant Thompson,
who was a member of the board of county commissioners, a member of the
board of education, and he undertook to exercise the duties of both offices.
This Court held that he was ineligible to discharge the duties of county com-missioner
; that when be accepted the second office he thereby vacated the one
he already hold. His right to act as a member of the board of education was
not questioned. In the case at bar the persons named in the judgment have
not been elected or appointed to any other office, but the added duties of the
county board of health have been placed upon the offices they already held, and
as long as they retain such offices they must discharge such duties, and when
they vacate such offices their successors must continue to perform them. By
discharging the duties of the board of health and acting as members of that
board those gentlemen did not vacate their offices they already held, for the
moment they resigned or vacated such offices they at once became ineligible to
continue as members of the board of health. For this reason they could have
BULLETIN N. C. BOARD OF HEALTH. 25
no right to elect which office they would take—the offices they held or member-ship
on the board of health. This legislation is not novel in North Carolina
—
nor, indeed, in the other States of the Union. In 1901 the Legislature passed
a similar act, section 4441 of the Revisal. That act provides that two physi-cians
shall be elected-—one by the chairman of the board of county commis-sioners,
and one by the mayor of the county town. who. together with the board
of commissioners, shall constitute the county sanitary committee, of which
committee the chairman of the board of county commissioners shall be ex
officio chairman.
We also have the familiar case of the Governor, who is made by law a
trustee of the University of the State and chairman of the board, and is
required to perform these duties and also act as chairman of the executive
committee of the trustees. Similar legislation is to be found in other States
having a constitutional provision similar to ours. In West Virginia the law
requires the Governor, Auditor, Treasurer, Superintendent of Schools, and
Attorney-General to serve on the board of public work, and prescibes the duties
of said board. The Court of Appeals, in an elaborate opinion, held the act valid.
saying, in substance, it simply prescribes additional powers and duties to be
performed by officers already elected by the people, and that it does not amount
to an appointment to an office created by law, but that it only amounts to
requiring the officers of the executive department elected by the people, to act as
members of the board of public works ; that it in substance simply annexes
additional powers and duties to their respective offices. The Court goes on
to say "that it is a time-honored usage in Virginia, and continued in West
Virginia, to cause certain duties which might have been assigned to officers
specially appointed or elected for the purpose, to be performed by officers
already appointed for general service." Bridges v. Shallcross, 6 W. Va., 57S.
citing Wales v. Belcher, 20 Mass., SOS. The question is considered, by the
Court of Appeals of Virginia in Sharpe v. Robertson, 5 Graft., 51S. In that
case certain duties were assigned the circuit judges to be performed in the
Court of Appeals and special compensation fixed by the General Assembly.
Judge Baldwin, speaking for the Court, says:
"But the act in question creates no new judicial offices and appoints no addi-tional
judges, but merely attaches new duties for offices existing to be per-formed
by the incumbents, within the constitutional power of the Legislature."
The subject is discussed by the Supreme Court of Texas in Powell v. Wilson.
16 Tex., p. 59, and the views we have expressed herein are fully supported.
The Court says : "It cannot be doubted that it is competent for the Legislature
to create an office, which shall be that of a substitute, or mere auxiliary to
another, the duties of which shall commence and consist in performing the
duties of the principal office." The subject is elaborately discussed by the
Supreme Court of Florida in Wilkins v. Conners, 27 Fla., 329, and it is held
that the statute making it the duty of the Sheriff of Escambia County to act as
city marshal of Pensacola is not obnoxious to the Constitution of that State,
declaring that "No person shall hold or perform the functions of more than
one office under the government of this State at the same time." In Louisiana
the same view is taken in State v. Somnie, 33 La. Ann., 237, where it is held
that the act providing that the clerk of the district court shall be ex officio
member of the jury commission does not confer an additional office upon the
incumbent of the clerk's office in violation of the constitutional restriction.
We could multiply authorities in support of these views, but deem it unnec-essary.
It is true, as contended, that section 9 uses this expression, "The term of
office of members of the county board of health shall terminate on the lirsi
Monday In January in the odd years of the calendar, and while on duty shall
receive $4 per diem, to be paid by the county." The former law declared their
term of office to be coterminus with that of the commissioners with whom they
serve, and when on duty they shall receive the same compensation as is
received by county commissioners. Evidently the language of the new act in
reference to term of office applies only to the two physicians who are chosen
as members of the county board of health by the chairman of the board of
county commissioners, by the mayor, and by the superintendent of schools.
26 BULLETIN N. C. BOARD OF HEALTH.
The change in the verbiage is due to the fact that there is a difference in the
terms of the ex officio members of the county board of health. The county
superintendent of schools goes out of office on the first Monday in July of each
year: the mayor of the county town, as a rule, goes out in May or June, while
the terms of the county commissioners expire in December. It evidently was
not intended to either leave a vacancy in the health board or to shorten or
lengthen the terms of the ex officio members. The person holding the office of
county commissioner when his successor is elected as chairman of the board
of county commissioners on the first Monday in December would go off the
county board of health and the succeeding chairman of the board of county
commissioners would co instanti become a member of the county board of
health. The same is true of the mayor and of the superintendent of public
schools.
Our conclusion being that the entire section of the act is a valid exercise of
legislative power, it is unnecessary to discuss the powers of the health board as
a de facto organization with a colorable right to discharge the duties imposed
upon it.
3. It is contended that the secretary of the State board did not fix the fees
as required by the act. We fail to see how this affects the plaintiff's title to
the office. It is plain that the secretary undertook to fix the fees to which
plaintiff would be entitled, but whether he observed the standard laid down by
the statute is not for us to determine in this proceeding. The statute, section
9. declares that the compensation of the superintendent of health for the
county, when fixed by said secretary, shall be "in proportion to the salaries
paid by other counties for the same service, having in view the amount of taxes
collected by said county."
And the same section declares that "all expenditures shall be approved by
the board of county commissioners before being paid."
It thus becomes the duty of the board of commissioners to pass on and audit
the plaintiff's accounts for services and to determine whether they are within
the bounds fixed by the statute. The approval of the defendant board is neces-sary
to the payment of plaintiff's account, and while the court will not under-take
to compel the county commissioners to approve them, it will require
them to consider the account and to pass on it in good faith in the exercise of
a sound judgment as to whether or not the services as charged are warranted
by the statute.
4. It is contended that mandamus is not the proper remedy, but that quo
warranto is. This contention is based upon the theory that one Dr. Stevens is
in possession of the office of "county superintendent of health" for Wake
County and exercising its functions. We find nothing in the record that gives
Dr. Stevens even a colorable title to the office or indicates that he is in pos-session
of it. The resolution of the county commissioners does not purport
to elect him superintendent of health or even to induct him into any office
established by law. If he is in the service of the county commissioners under
their resolution, a "county physician" (the term used in the resolution), then
he is merely a contract physician performing services which should be per-formed
by the plaintiff, and is not exercising the functions of a public office.
He has not even a colorable title to the office of "county superintendent of
health." He is not a party to this proceeding and was very properly omitted.
That mandamus is a proper remedy to enforce plaintiff's demands is estab-lished
by abundant authority. Moore v. Jones. 76 N. C. 1S5; Doyle v. Raleigh.
89 N. C. 133 ; Lyon v. Commissioners. 120 X. C. 239 ; Koonce v. Commissioners.
lOfi N. C. 192.
We assume that when this opinion is handed down it will be unnecessary for
plaintiff to sue out the writ; but in case it is. the plaintiff may apply for a
peremptory writ of mandamus to the judge of the Superior Court residing in
or holding the courts of the Sixth Judicial District.
The costs of this appeal will be paid by defendant board of commissioners.
Reversed.
BULLETIN N. C. BOARD OF HEALTH. 27
-McCULLERS CASE NOT ENDED.
County Attorney Beckwith Says Board Will Recognize Dr. McCullers, But
Appeals to the People for Final Judgment.
To the Editor of the Times: The board of commissioners for the
county of Wake is not resentful to criticism. It recognizes the preroga-tive
of the press to impeach and the right of the people to condemn any
official act of a public servant.
The Times having often exercised its high prerogative by impeaching
with vigor, though the people have not yet condemned, the board of com-missioners
for presuming to defend the supposed constitutional right of
the people to local self-government, and the right through their chosen
commissioners "to exercise a general supervision and control of the penal
and charitable institutions and finances of the county," will not, I pre-sume,
close its columns to this communication. I ask nothing but an
open field.
]^o doubt, the board of commissioners itself will not stand mute, when-ever
called upon by the people who elected them, to answer concerning
its action in questioning the legal right of a secretary of the State Board
of Health to foist upon a county an officer and fix his compensation with-out
the approval of the board of commissioners whose constitutional and
legal duty, it had been thought, was to have general supeiwision and con-trol
of the affairs, especially the financial affairs, of the county. And
I. as citizen and as attorney, shall not be silent whenever the inherent,
fundamental right of the people to local self-government is challenged
by any, on any pretext, or is taken away by act of Assembly under the
specious guise of protecting the public health.
But I shall not at this time trespass upon your space with long lists of
facts and figures, or fatigue your patience by a long string of reasons
for the board's action in defending the McCullers case, but shall be as
brief and pointed as possible. Enough to say, they held it to be their
sworn duty.
On the second Monday in May, 1911, the county board of health (a
new creation by the last Legislature), composed of the mayor of the
county town, the county superintendent of schools, the chairman of the
board of county commissioners, and two physicians chosen by them, met
and elected Dr. J. J. L. McCullers to the position of county superintend-ent
of health, a new office created by chapter 62, Public Laws 1911.
At the regular monthly meeting of the board of county commissioners,
June 7, 1911, the members of the county board of health, together with
a number of individual citizens, appeared before the board of commis-sioners
and requested approval by the board of a proposed salary of
twenty-five hundred dollars ($2,500) a year to be paid Dr. McCullers as
county superintendent of health, out of the general county fund.
Having listened to arguments by the visitors and having given the
matter due consideration, the county commissioners did not feel justified
in approving of $2,500 to be paid out of the county treasury to a superin-tendent
of health, as the board knew that the proposed salary was greatly
in excess of that for which identical service could be obtained; so the
board passed a resolution directing the payment, out of the general fund
*Raleigh Evening Times, February 29, 1912.
28 BULLETIN N. C. BOARD OF HEALTH.
of the county, of the sum of six hundred dollars ($600) a year as com-pensation
or salary to the county superintendent of health, providing he
discharged certain duties therein specified, and deducting so much from
said salary for his negligently failing to perform the same.
Although Dr. MeCullers had been an active candidate for reelection
to the office of county superintendent of health or county physician at a
salary of $50 a month (the salary he had received during former terms
in that office) prior to the passage of said chapter 62, yet after the pas-sage,
on March 7, 1911, of that act (which seemed to open wide the doors
of the county treasury) and after the board of county commissioners had
withheld its approval of the $2,500 salary proposition, submitted by the
county board of' health, Dr.' MeCullers refused to qualify by not taking
the oaths of office, thereby creating a vacancy in the office of county
superintendent of health.
Instead of proceeding to fill the vacancy by electing another, as was
their duty, under the law, the county board of health on the .... day of
July, 1911, sixty days after Dr. MeCullers' declination had been received,
met and passed a resolution humbly petitioning Dr. W. S. Kankin, secre-tary
of the State Board of Health, to appoint a county superintendent
of health for Wake County, kindly suggesting therein Dr. MeCullers as
a fit person for the job.
Dr. Kankin graciously consenting, on the 17th of July, 1911, wrote
Dr. MeCullers of his appointment, having favorably considered the
prayers of the county board of health in his behalf, and fixing his com-pensation
by a schedule of fees—on a very remunerative basis indeed
—
although he was advised that to fix the compensation of a county super-intendent
of health on a fee basis, for this county, would be to fly in the
face of the legally established policy of Wake County against the fee
system of paying county officers. But who cared for that ? In the words
of a Vanderbilt, "The people be damned" with their policy
!
The board of commissioners being advised that Dr. Rankin's appoint-ment
of Dr. MeCullers was ultra vires and void, and that his compensa-tion
under the schedule of fees fixed by the secretary of the State Board
of Health was grossly excessive, unjust to the county, and contrary to
law, refused to recognize Dr. MeCullers as county superintendent of
health on a fee basis, and withheld approval of his bills—one of which
amounted to $89.50 for eleven days ordinary professional service. Upon
this as a basis of calculation, Dr. MeCullers' fees as county superin-tendent
of health would exceed $3,000 a year; and as like seiwiee could
be had of other skilled physicians for $600 a year, or $50 a month, the
county commissioners could not feel justified in approving bills based
upon a schedule of fees so unjust to the county.
On the 2d day of November, 1911, Dr. MeCullers brought his action
against the board of commissioners, demanding a writ of mandamus
compelling the board of commissioners to recognize his appointment as
county superintendent of health, and directing said board to audit and
approve his bills. The board of commissioners, answering his complaint,
among other things, alleged that section 9 of chapter 62, Public Laws
1911, was unconstitutional and void; that the secretary of the State
Board of Health had not authority to appoint ; that the compensation
arising out of said schedule of fees as fixed by Dr. Kankin was grossly
BULLETIN N. C. BOARD OF HEALTH. 29
excessive in that it would amount to more than $3,000 a year ; that man-damus
would not lie to compel "approval"; that Dr. W. S. Stevens, a
skilled physician, was filling said office and performing the duties thereof
for the sum of $50 a month, and moved the court to dismiss the action.
The Superior Court sustained the contentions of the board of commis-sioners
and rendered judgment dismissing the plaintiff's action. From
that judgment Dr. McCullers appealed to the Supreme Court. By an
opinion recently handed down (and published in full in The Times,
with editorial comment not complimentary to the board of commis-sioners),
the Supreme Court reversed the judgment of the court below,
holding that section 9 of said chapter 62 was constitutional; that Dr.
Rankin had authority to appoint, and that Dr. McCullers was entitled
to the office. But the Court also held that Dr. McCullers' compensation
must be passed upon and approved by the board of county commissioners
before being paid, leaving the amount of the same to be determined in
the sound discretion of the board of commissioners, under the law, what-ever
that may mean.
Being law-abiding citizens, the board of commissioners, in obedience
to the opinion of the Supreme Court, will of course recognize Dr. McCul-lers'
title to the office. But from that opinion they appeal to Caesar—to
the people themselves. I submit for their verdict and final judgment,
the following issues
:
1. Shall an act, such as section 9 of chapter 62, Public Laws 1911, as
construed and held to be, depriving the people of the inherent right of
local self-government, taking from them their control of local domestic
affairs, remain on the statute books?
2. Shall the constitutional right of the people, exercised through their
chosen boards of commissioners, to general control and supervision of
the penal and charitable institutions and finances of the county be trans-ferred
from their hands into and remain in the hands of one man—
a
secretary of a State board—not elected by or answerable to the people ?
3. Shall the ultimate power of appointing to a vacancy in a county
office be and remain lodged in the hands of a secretary of a State board,
and shall the salary or fees to be paid a county officer out of the county's
general fund depend upon a schedule of fees fixed by or be measured by
a standard created by the whim or prejudice or at the arbitrary will of
a secretary of a board not elected by or answerable to the people ?
4. If in their opinion it be contrary to the public interest, shall the
board of commissioners be compellable to approve and pay bills for
fees, that may aggregate $3,000 and more a year, to a county physician
not elected by them or the people, for professional services, when like
service can be had from another equally skilled, for $600 a year? And
if so, why?
5. Shall the people demand of their representatives in the General
Assembly a pledge to restore to the counties control of their local domes-tic
affairs by repealing or amending cliapter 62, Public Laws 10 1 1 '.
Upon these issues, of far more vital interesl to the people of Wake
County than which one of the four distinguished candidates slinll be
United States Senator, as involving preconstitutional, inherent rights of
the people to local self-government, I shall be beard, in due season, in
the forum of the people. B. C. Beck with.
30 BULLETIN N. C. BOARD OF HEALTH.
*DR. RANKIN ON THE SITUATION.
SECRETARY OF STATE BOARD OF HEALTH REPLIES TO COUNTY
ATTORNEY—THINGS POINTED OUT.
Dr. Rankin Shows Why it is Duty of State, When County Refuses to Provide
Protection, to Step in and Take Care of Whole People—Basis for Remu-neration
$1,200 or $1,500 a Year, and not $3,000, as Claimed by County
Attorney and Commissioners—Interesting Communication.
To the Editor of The Times: Your paper under date of February 29
contains an article from Mr. B. C. Beckwith, attorney for Wake County,
and, presumably, spokesman for the Wake County Commissioners, to
which a reply from the secretary of the State Board of Health may not
be altogether out of order.
SUM AND SUBSTANCE OF MR. BEOKWITh's ARTICLE.
A fair, unbiased mind, on carefully reading the aforesaid article with
its five conclusions, stated as issues, can reduce all that Mr. Beckwitk
claims to two and only two contentions
:
First, that section 9, chapter 62, Public Laws of 1911, under the com-mand
of which the secretary of the State Board of Health acted in
appointing Dr. J. J. L. McCullers county superintendent of health of
Wake County, is in violation of that which all good citizens prize as
their most fundamental right—local self-government ; second, that the
basis of remuneration for the services of the county superintendent of
health of Wake County, as fixed by the aforesaid secretary, is wrong in
principle and excessive in amount.
We deny both of these contentions, and respectfully submit the follow-ing
facts and conclusions in support of our position
:
STATE HEALTH LAW AND LOCAL SELF-GOVERNMENT NOT INCOMPATIBLE.
This is best brought out by an examination of the provisions of sec-tion
9, under which Mr. Beckwith contends the State Board of Health
is given authority that interferes with local self-government. Section 9
is as follows
:
The chairman of the board of county commissioners, the mayor of the
county town, and in county towns where there is no mayor, the clerk of the
Superior Court, and the county superintendent of schools shall meet together
on the first Monday in April, one thousand nine hundred and eleven, and there-after
on the first Monday in January in the odd years of the calendar, and
elect from the regularly registered physicians of the county, two physicians,
who, with themselves, shall constitute the county board of health. The chair-man
of the board of county commissioners shall be chairman of the county
board of healtb. and the presence of three members at any regular or called
meeting shall constitute a quorum. The term of office of members of the
county board of health shall terminate on the first Monday in January in the
odd years of the calendar, and while on duty they shall receive four dollars
per diem, to be paid by the county. The county board of health shall have
the immediate care and responsibility of the health interests of their county.
They shall meet annually in the county town, and three members of the board
are authorized to call a meeting of the board whenever in their opinion the
*Raleigh Evening Times, March 4, 1912.
BULLETIN N". C. BOARD OF HEALTH. 31
public health interests of the county require it. They shall make such rules
and regulations, pay such fees and salary, and impose such penalties as in their
judgment may be necessary to protect and advance the public health : Pro-vided,
that all expenditures shall be approved by the board of county commis-sioners
before being paid. At their first annual meeting on the second Monday
of May, one thousand nine hundred and eleven, and thereafter on the second
Monday of January in the odd years of the calendar, they shall elect the
county superintendent of health, who shall serve thereafter until the second
Monday in January of the odd years of the calendar: Provided, that if the
county board of health of any county shall fail to elect a county superintendent
of health within two calendar months of the time set in this section, the secre-tary
of the State Board of Health shall appoint a registered physician of good
standing in the said county, who shall serve the remainder of the two years,
and shall fix his compensation, to be paid by the said county, in proportion to
the salaries paid by other counties for the same service, having in view the
amount of taxes collected by said county.
This section, be it observed, places the care of the public health of the
county in the hands of a board composed of men who, in a county where
there are several political factions, would represent, in all probability,
no one faction, and of men who, judging from their official positions,
have the ability to appreciate their important responsibilities in connec-tion
with the public health. In other words, the county board of health
is, as near as it is possible to make it, a body free from politics, it being
recognized by the General Assembly, and all others who properly appre-ciate
the importance of the public health, that the health and life of the
people should not be used as an asset of politicians wuth which to pay
off their political obligations.
In this county the board of health is composed of Hon. D. T. Johnson,
chairman, board of county commissioners; Hon. J. I. Johnson, mayor,
city of Ealeigh; Mr. Z. V. Judd, Dr. Henry Mclvee Tucker, and
Dr. G. M. Bell. I respectfully submit that this body compares favorably
in ability and in devotion to the people's interest with the Wake County
Board of Commissioners, or even with their learned legal adviser, so
zealous in the protection of the people's interest.
Be it observed that under the law the county authorities have two
months in which to provide an official whose duties are literally vital to
the welfare of the public. Failing in this ample time to discharge this
important function of their office, the State steps in, overrides official
inertia or breaks a deadlock and gives the county a legally responsible
official with authority to protect the health and lives of the people. And
this is what Mr. Beckwith terms an interference with local self-govern-ment.
But why, if the accredited representatives of the people of a county
really desire no legally responsible health officer clothed with the power
of a sovereign State to enforce the laws that stand between pestilence and
life, should the State insist upon their having one? Is such a condition
not their own affair? Xo, and no ever since the Judge of judges declared
that "no man liveth unto himself." No, because natural laws enacted
by the Legislator who never erred, and which are not subject to repeal
by a board of county commissioners, enforce the afore-quoted principle
of life through the agency of infection—an agency that respects no
county boundary, an agency more active as our civilization grows in
complexity and the facilities of travel are improved, an agency, operative
32 BULLETIN N. C. BOARD OF HEALTH.
through bonds of common suffering and sympathy, that is drawing the
great human family into a more mutually dependent, powerfully cooper-ative
organic whole. To conclude our reply to Mr. Beckwith's first con-tention
: Those who admit the operations of those divine or natural laws
which we have just referred to must concede that the State owes to her
confederate counties protection from any county which, for any reason,
fails after the lapse of a reasonable time to provide an official who can
be held legally responsible for disease-disseminating nuisances and epi-demics
that endanger, disable, and kill the citizens of neighboring and
even distant counties.
THE SYSTEM OF REMUNERATION FOR COUNTY HEALTH WORK.
There are two ways to render a bill or account : one in the form of a
lump sum "for services rendered," in which the particular services ren-dered,
the items, are unstated and unknown; the other, in the form of an
itemized statement in which each particular service rendered, with the
amount charged for it, is so stated as to be subject to public investigation,
and if necessary, criticism. To fair-minded people we respectfully sub-mit
'that where there is likelihood of a controversy over an account, it is
safer and wiser to have the account submitted item by item. The public
can then see exactly what they are paying for each service and criticism
may be specific, to the point. Recognizing the likelihood of a contro-versy
we declined the advice of friends and deliberately authorized a
basis for remunerating the county health officer so that he would be paid
only for what he did and so that the amount paid for each item of
service could be seen by any one interested. So much for the "fee sys-tem"
; and now a few words in regard to
THE AMOUNT OF REMUNERATION.
The law requires the secretary of the State Board of Health to fix the
compensation of a county health officer, appointed by him, in accordance
with salaries paid by other counties of equal wealth for such service.
Now let us see how Wake County compares m wealth with other
counties, and what some of the other counties are paying their health
officers
' Wake is the second county in population, second in size, and
fourth in wealth of the counties of North Carolina. The salary of $600
a year which the commissioners wanted to pay their health officer would
place Wake seventeenth in the list of counties in the total salary paid
the health officer, or, if we look at the amount paid the officer from a
per capita standpoint, Wake would be forty-fifth among the counties
The schedule of fees fixed as the basis of remuneration for the health
officer of Wake County will aggregate in a year about $1,200 to $1,500,
and not $3,000, as claimed by Mr. Beckwith. The eleven days service
for which a bill of $89.50 was rendered were the last eleven days of the
month when Dr. McCullers took charge of the work. All of the county
institutions had to be inspected in that time, and there was in all proba-bility
an unusual amount of sickness among the wards of the county at
the time. Now that Dr. McCullers is to be officially recognized, we con-fidently
leave to the next two or three months the refutation of Mr.
Beckwith's claim that the health officer's compensation will aggregate
$3 000 a year. It will not exceed $1,500 a year, and we believe that, it
BULLETIN N. C. BOARD OF HEALTH. 33
that provision of the law which permits the county health officer to save
mileage to the county by employing the nearest regular physician to a
convict camp or county home to attend a sick inmate is duly regarded
by the health officer, the amount paid for this work will not exceed $1 ,200
a year. "We fixed the compensation of the health officer just as the law
prescribes, that is, in accordance with the compensation of health officers
in other counties of the State of like wealth to Wake.
But Mr. Beckwith says that a skilled physician could be obtained for
$600 a year, and he leaves the inference that all in excess of that amount
paid the county health officer is gross extravagance. Was the skilled
physician employed the cheapest available? What county offices or State
offices could not be filled by cheaper men than their present occupants?
And some of the cheaper men would be just as efficient officials as a few
now in office. Even the office of Wake County attorney might be let to
a cheaper man, and one, too, who would not put his county to an expense
which will exceed the cost of an entire year's health work by contesting
in the courts the constitutionality of an act that the Supreme Court
unanimously upheld.
The laws affecting officeholding do not recognize the lowest salary for
which officials may be obtained as the best salary to attach to an office.
An equitable compensation sufficient to secure the application of muni/
good men gives the electors the privilege of exercising some choice in the
selection of officials. A salary so small as to restrict the electors to only
a few men in filling important offices is detrimental to the public welfare.
For fifteen years the salary of the health officer of Wake County has
ranged between $500 and $600 a year. During this time the population
has increased 20 per cent, the wealth 40 per cent, new duties have been
added to the health office, and science has multiplied the opportunities
and increased the responsibility of these officials. With a salary of only
$600 a year for the health officer, the choice of the people must become
more restricted as the county develops.
Wake should be in the same class with Guilford, Kobeson, Durham,
and JNTew Hanover, where health officers are employed at salaries of from
$1,800 to $2,500 and give their entire time to their work. Certainly we
should not pay less than $1,200 a year, which will permit the health
official to not only visit the sick in county institutions, but to do thai
which is far more important, carry on an aggressive campaign of disease
prevention.
The choice of a health officer was left entirely with the authorities
whom the law appoints to make this selection. The county board of
health recommended Dr. J. J. L. Meddlers for the place, and recog-nizing
the fundamental principle of local self-government, he was
appointed by the writer. It was after the recommendations of the county
board of health had been acted upon by the State Board of Health that
the commissioners went out, sought, and obtained a physician who a
to do certain of the county public health work for $600 a yen-.
We repeat that, any vacancy in county offices filled by appointment at
an equitable salary could be criticised on the ground that after the office
was so filled, another person could be found who would agree to accept
the office for a smaller remuneration. W. S. Rankin,
Secretary State Board of 11 alth.
34 BULLETIN N. C. BOARD OF HEALTH.
*MR. BECKWITH COMES AGAIN.
REPLIES TO DR. RANKIN IN THE COUNTY SUPERINTENDENT OF
HEALTH MATTER—QUESTION OF RIGHTS.
Issue Not One of Men, But of Rights Older Than the Constitution—County
Commissioners Abide by the Law as Interpreted, But They Have an Abid-ing
Faith that the Rights of the People to Manage Their Own Affairs Shall
Not Be Permanently Abridged—Not Afraid of a Writ of Mandamus.
To the Editor of The Times: In an editorial commenting on the
county attorney's communication in the McCullers case, you said he
"missed the point." Maybe so. But in shelling the woods he (the
county attorney) unmasked and drew the fire of a heavy battery support-ing
the line of attack against the rights of the people of Wake County
to govern themselves and to attend to their own local affairs.
But, unless the unmasking of the Doctor's battery riled him, there was
and is no cause for a rise of temperature in the office of the secretary of
the State Board of Health; for "I am not mad, most noble Festus; but
speak forth the words of truth and soberness"—appealing to Csesar,
that the people may know the inwards of this matter.
The vital issue in the McCullers matter shall not be clouded by hot
vapors blown into the face of the county attorney, or obscured by dust
flung at the heads of the county commissioners.
The issue is not men, but measures. And it is the iniquitous measures
contained in the "health act," that the secretary of the State Board of
Health boasts were unanimously upheld by the Supreme Court, to
which the people felt constrained to hold that the enactment of chapter
62 of the Public Laws of 1911 "was a valid exercise of legislative power"
;
the Court did not hold that it was a just exercise of that power.
With all due deference that a lawyer owes the opinions of that high
Court, that act, as interpreted, deprives the people of Wake County of
their inalienable right of local self-government, and in great measure
takes away their constitutional control of the penal and charitable insti-tutions
of the county, and ought to be, if it is not, unconstitutional and
void as contravening the spirit of local self-government which underlies
the Constitution and is inherent in the people, for the people did not
surrender that right when they adopted the Constitution.
That act, as interpreted, places in the hands of an "Outlander" secre-tary
of a State board the ultimate power of appointing and fixing in fees
the compensation of a county officer, who has superior control of large
interests of the county, and that too without consulting the wishes of the
people as to their choice and contrary to the legally established policy of
the county against the vicious and corrupt fee-system county officers.
Let us see if it does not, by quoting here from the act itself : "Pro-vided,
that if the county board of health of any county shall fail to elect
*Raleigh Evening Times, March 9, 1912.
BULLETIN N. C. BOARD OF HEALTH. 35
a county superintendent within two months of the time set in this action
[which the county board of health, for causes best known to themselves,
promptly proceeded to 'fail' to do], the secretary of the State Board of
Health shall appoint a county superintendent of health, and fix his com-pensation
to be paid by the county"-—both of which powers the said
secretary of the State Board of Health very promptly exercised without
consulting the county commissioners, the ones most interested, although
they, through their chairman, asked to be considered as being interested
for the county in both the officer and his pay. The choice of the secre-tary
fell upon that one whom the county board of health, having failed
to reelect, humbly petitioned the secretary of the State Board of Health
to appoint. Of course
!
The county board of health having authority under the act to fill the
vacancy occasioned by Dr. McCullers' declination to qualify upon the
May election, and after the board of commissioners had recognized his
title to the office under that election, but had declined the proposition of
the county board of health to approve a salary of $2,500 to be paid by
the county, but had approved of a salary of $600 a year—a just and rea-sonable
compensation for the work to be done—the questions naturally
arise: Why didn't they reelect Dr. McCullers? or why their delay for
two months in electing another, till Dr. Rankin's power of appointing
attached and became operative? and why humbly petition, as to a supe-rior,
Dr. Rankin to appoint Dr. McCullers, and to fix his fees after Mc-
Cullers had eliminated himself by declining their May election ?
'Tis here the people smell the nigger in the woodpile, and ask: Hoav
cum ?
Was the county board of health fearful of the people's disapproval of
its choice? Was the salary or fees demanded by their chosen one more
than they thought the people would stomach? Or, fearing to face
the people with their choice and his bills for fees, did they deliberately
shield themselves from wrath to come behind the secretary of the Slate
Board of Health, who does not owe his lucrative office to the favor of the
people, and cannot be called to account by them for appointing a man
to office and fixing his compensation on a condemned fee basis and on
an excessive amount, many times greater than the $600 a year salary
that others, just as good, were willing to accept as compensation for
their services ?
That high-handed invasion of and disregard of their constitutional
rights forced the commissioners to call a halt and to defend the suit
brought against the board of commissioners by Dr. McCullers. 'The
commissioners did not seek to begin the fight. They have acted in self-defense,
in the interest of the county.
But the secretary of the State Board of Health says: "I respectfully
submit that this body (meaning the county board of health) compares
favorably in ability and devotion to the people's interests with the
Wake County Board of Commissioners, or even with their learned legal
adviser, so zealous in the protection of the people's interests."
Why throw that handful of dust? Who has questioned their ability
or devotion? Let it be granted that they excel in these virtues; yr\ if
36 BULLETIN N. C. BOAED OF HEALTH.
the acts and the words of the secretary of the State Board of Health he
taken, the fact remains that they failed to discharge a legal official duty,
thereby shifting their sacred responsibility for the health of the people to
the hands of the secretary of the State Board of Health, who (and what
more could he said) condemns them after this fashion: "Be it observed,
that under the law the county authorities (meaning the county board
of health ) have two months in which to provide an official whose duties
are literally vital to the welfare of the public; failing in this ample time
to discharge this important function of their office, the State steps in,
overrides official inertia or breaks a deadlock, and gives the county a
legally responsible official with authority to protect the health and lives
of the people. And this is what Mr. Beckwith terms an interference
with local self-government."
And Mr. Beckwith is correct; for by contrived negligence, procured
concert of action, political cowardice or combination or fear of responsi-bility,
the ultimate choice of a county health officer in every county and
the fixing of his salary or fees is put into the hands of a mere secretary
of a State board, and the people are thus deprived of selecting their own
officer or of fixing his pay. But they have the inestimable privilege
and pleasure of paying the bills.
And with this privilege left them by this "health act," the people
ought to be content. Are not their backs broad? Surely they ought to
be glad to pay fee- that will enable their county doctor to ride to this
camp and from that institution in style befitting the appointee of the
secretary of a State board !
The secretary of the State Board of Health, in his four-column com-munication,
quoted a part of section 9 of the "health act." But he did
not quote the following pregnant proviso :
"Provided, that the county superintendent of health shall have the right to
employ and to lix the compensation of any other regularly registered physician
of his county, to perforin any or all of the duties pertaining to the jail, county
home, or convict camps when in his judgment it is desirable to do so."
Bead that over, and read it yet again, and then go back and gently
and prayerfully, if you can, glide through that provision, word by
word, and then wonder at the sublime patience of boards of county com-missioners.
In the words of the immortal Vance, "My God, Aber-nathy
!" Here we have the appointee of an appointee (neither of whom
is answerable to the people) given discretionary power to appoint yet
another officer and to fix his fees without limit to anything. And yet
the county commissioners pay a fee salary of $2,500 or more—plus
whatever the county superintendent of health may see fit "to fix" for
that other doctor, and be glad it's no worse, or go to jail.
They boast that the Supreme Court has upheld the validity of their
act and gloat over what they allege is the failure of the board of com-missioners
to place a barrier between these appointees and the treasury
of the people, and threaten with a peremptory bill of mandamus, and
thus, by implication, with the jail, the commissioners of the people if
they dare refuse approval of their bills.
BULLETIN N. C. BOARD OF HEALTH. 37
To their interpretation of their act and of the opinion of the court the
board of county commissioners has not yielded and will not assent, if
they follow the advice of the county attorney, till such time as they shall
have exhausted every legal means of resistance at their command.
We believe the people of Wake are willing that their chosen commis-sioners
should spend the public money in defending the people's right
to choose their own local servants, fix their pay, and manage their own
domestic affairs. They would justly condemn their servants for failure
to defend to the uttermost any attack on the right of the board of com-missioners
to watch over and safeguard the county treasury against
spoliation, even under the specious guise of protecting the public health.
Now, the county attorney has no personal quarrel with any. The
issue is far above mere persons. It involves rights older than our Con-stitution—
that were hoary with age before the Boston tea party; rights
fought for and won back by ville and town and Mark from King, and
baron, and abbot, who had with iron hand or lying tongue, by force or
fraud, taken them from the people; rights that our forefathers, even
here, thought worthy of being maintained with treasures and blood at
Alamance, at Moore's Creek, at Guilford Courthouse, at Kings Moun-tain,
and made good at Yorktown—the right of local self-government
and the control by the people of their own money.
The extortions of the fee system (again attempted to be fixed on us by
this secretary) of paying officials was one of the main grievances that-led
to the regulator troubles of our fathers.
The board of county commissioners while bowing to this act (for law
it is, though of questionable parentage) as interpreted by the Supreme
Court, in recognizing Dr. McCullers' title to office, still have an abiding
faith that soon again the constitutional "right of the people of the
county to manage their own affairs shall not be abridged or denied
except under the pressure of a plain and positive requirement and when
no alternative in the law is admissible." We devoutly pray that the
court may soon return to the sound law of that opinion. And in the
words of a learned associate justice of our Supreme Court, used in Jones
v. Commissioners, 135 N". C, 223, we pray it may soon again be held
to be "without precedent in this State, if the Legislature should assume
to know the wishes and interests of the people of any county better than
the county commissioners." In this case, it is not the Legislature only,
but a board of health and a secretary of a State board who has assumed
to know the wishes and interest of the people of Wake County belter
than the county commissioners, the duly elected servants of the people
and answerable to them for the proper management of the affairs of the
county.
In conclusion, I want to say that I assume full responsibility for hav-ing
the board of commissioners not to recognize the authority of the
secretary of the State Board of Health to appoint a county superin-tendent
of health and to fix his compensation on a fee basis, to be paid
by the county, contrary to the legally established policy of this county,
till they were compelled to do so, by the order the Supreme Court. 1
also have advised them not to surrender, without a fight to a finish, the
38 BULLETIN N. C. BOARD OF HEALTH.
theretofore supposed right of the hoard of commissioners in its sound
<li
- -l'etion to disapprove and not allow payment of any disputed claim or
demand against the county until the justness and reasonableness of the
claim or demand had been determined.
I shall continue to advise them, so long as they ask my advice. I
shall never advise them to tamely surrender the people's right to local
self-government—the right to control their purely local affairs—into
the hands of any one man or body of men, under any pretext whatsoever.
When the courts unquestionably decide that they have not the discre-tion
to approve or disapprove claims against the county, but that the
board of commissioners is a mere auditing committee whose only duty
is to add up columns of figures, to see that the addition, subtraction,
or multiplication is correct, then I shall advise them, but not till then, to
be afraid of a writ of mandamus. B. C. Beckwitii.
NONPARTISAN BOARD OF HEALTH.
The Object of New Health Law—Compared to School Board.
To the Editor of The Times: The last article that appeared in your
paper from Mr. Beckwith was very largely a repetition of his first com-munication
relative to the McCullers case. There was a more extensive
criticism of the Wake County Board of Health and less about the remun-eration
of the Wake County health officer than in his former article. He
makes about the same effort to prejudice the popular mind against a
fundamental principle in health administration, to wit, the divorcement
of the county health work from politics in almost exactly the same way
in which the county educational work has been removed from political
influence.
THE QUESTION OF REMUNERATION.
The law regulating the fixing of the remuneration of a county health
officer by the secretary of the State Board of Health is in these words
:
"shall fix his compensation, to be paid by the said county, in proportion
to the salaries paid by other counties for the same service, having in
view the amount of taxes collected by said county." In strict accordance
with that law. I fixed the remuneration of the Wake County health officer.
I proved this conclusively in my reply to Mr. Beckwith's first article by
citing the position of Wake among the other counties of this State in
respect to comparative wealth, size, population, and the total and per
'tip/ 1 a amounts paid their health officers. Mr. Beckwith cannot refute
this statement. If the law had said, "shall fix his compensation in
accordance with the amount for which the lowest bidder agrees to dis-c-
barge the duties of county health officer," I could have secured a man.
very probably, for even less than $600 a year, and a man, too, who nos-sesses
those legal qualifications that entitle him to pass as a skillful
physician. But, if this were law, then the most important position for
a phvsician to occupy in any county would be let to the least qualified
physician.
BULLETIN JV. C. BOAKD OF HEALTH. 39
MR. BECKWITH'S BUGABOO TO LOCAL SELF-GOVERNMENT.
The General Assembly, the people's representatives, have placed the
health work and the school work of the counties which they represent
under the supervision of a county board of health and a county board
of education respectively. They have designated to serve on these boards
well-known and honored men of the county in which they serve. This
is no violation of the principle of local self-government, but the creation
of a nonpartisan agency, in the form of the two boards aforesaid, to
administer those two phases of local self-government that has to do with
the health, life, and education of the people.
Will a county educational system, in which the county commissioners
elect the county superintendent of schools and through him choose those
teachers whose friends can exercise the strongest political influence, give
you better educational facilities than our present system? Indeed it will
not. When boards of commissioners that represent political parties or
factions choose health officers, which will influence them most in their
choice of an official, his professional qualifications or his political power?
When they are considering the enactment of sanitary rules and regula-tions,
the abatement of nuisances such as the drainage of mill-ponds, the
removal of hogpens, etc., will political influences sway their judgment ?
Should it ? If the principle of nonpartisan control of health work of a
county is wrong, then the principle is wrong again when it is applied to
the management of our educational system. As a matter of fact, both
are right, and for that reason will be maintained.
A nonpartisan county board of health has an important and altogether
proper place in the machinery of county government and does not con-flict
with local self-government:. As such the Wake County Board of
Health began their official work on the second Monday in May, 1911.
Their first action was to unanimously elect a county superintendent of
health for his entire time and to recommend, for the approval of the
board of county commissioners, an annual salary of $2,500. The man
elected to the office of county superintendent of health was Dr. J. J. L.
McCullers. He was not the choice of the county commissioners ; they
wanted another man. Displeased with the action of the county board of
health in not electing their man, they passed the following resolutions
on the 6th of June, 1911
:
"Resolved, That th

Cbe Li&rarp
of tf?e
Onitoerjsitp of Jftortb Carolina
GEn&otoeli ftp Wbt ^Dialectic
anC
43i)tlantt)ropic &otittit0
N8fch
N/.Z7
Med. \ ib.
This book must not
be taken from the
Library building
LUNC-1SM F 40
THIS BULLETIN WILL BE SENT FREE TO ANY CITIZEN OF THE STATE UPON REQUEST
BULLETIN
OF THE
NORTH CAROLINA STATE BOARD OF HEALTH
Published Monthly at the Office of the Secretary of the Board, Raleigh, N. G.
Entered as second-class matter at Post Office at Raleigh, N. C... under Act of July 16, ISO!,.
J. Howell Way. M.D., President,Waynesville.
Richard II. Lewis, M.D., Raleigh.
Edw. C. Register, M.D., Charlotte.
J. E. Ashcraft, M.D., Monroe.
David T. Tayloe, M.D., AYashington.
J. L. Ludlow, C.E., Winston-Salem.
W. O. Spencer, M.D., Winston-Salem.
Thomas E. Anderson, M.D.. Statesville.
Chas. O'll. Lalghinghouse, M.D.. Greenville.
W. S. Rankin, M.D., Secretary and Treasurer, Raleigh.
John A. Ferrell, M.D.. Assistant Secretary for Hookworm Disease, Raleigh.
Vol. XXVII. APRIL, 1912. No. 1.
SANITARY SUNDAY EDITION
CO^TEKTS
Sax oaky Sunday : •»
A Growing Chubch and a Sick People 3
The Place of the Physical in Life 7
What the COUNTIES Are Doing 7
Messages from the Front on the Fight Against Smallpox . 8
The McCuixers Case 9
A Word to His Honor the Mayor 1"
The Sixth Commandment and its Interpretation . . . . . 12
Modern Application of the Pakable of the Good Samaritan . 14
Public Health Program for Preachers 15
Waste ir»
Full Text of Supreme Court Decision in M< Ci leers Case . . 23
Controversy Between Mr. B. C. Beckwith and Dr. W. S.
Rankin Oveb the McCullers Case 27-40
O
>
m
2:
o
L*
BOARD OF CONTRIBUTING EDITORS.
1. Governor W. W. KITCHIN, Raleigh, N. C.
2. Hon. A. II. ELLER, Winston-Salem, N. C.
3. Hon. E. W. SIKES, Wake Forest, N. C.
4. Hon. W. C. DOWD. Charlotte, N. C.
5. Mr. CLARENCE TOE. Raleigh, N. C.
6. Mr. ARCHIBALD JOHNSON, Thomasville, N. C.
7. Rev. GEORGE W. LAY, Raleigh, N. C.
s. Dr. HENRY L. SMITH, Davidson, N. C.
9. Dr. FRANCIS P. VENABLE, Chapel Hill, N. C.
10. Dr. W. P. FEW, Durham, N. C.
11. Dr. WILLIAM L. POTEAT, Wake Forest. N. C.
12. Dr. F. L. STEVENS, West Raleigh, N. C.
13. Dr. CYRUS THOMPSON, Jacksonville, N. C.
14. Dr. CHAS. O'H. LAUGHINGHOUSE, Greenville, N. C.
15. Dr. L. B. McBRAYER, Asheville, N. ('.
16. Dr. BENJ. K. HAYS, Oxford, N. C.
17. Dr. EDWARD J. WOOD, Wilmington, N. C.
IS. Dr. WILLIAM DeB. MacNIDER, Chapel Hill, N. C.
19. Dr. H. A. ROYSTER, Raleigh, N. C.
20. Dr. J. L. NICHOLSON, Richlands, N. C.
North Carolina
EDITORIAL
SANITARY SUNDAY—APRIL 28, 1912.
In accordance with an animal custom which we have followed for the
last two years, we are asking the ministers of the gospel to place special
emphasis on the question of community or puhlic health in their sermons
on April 28th.
From time to time, we have called attention to the many phases of
this vital problem which should serve to enlist the cooperation of the
Christian Church. The Bible is full of texts bearing on the problem of
public health. One of the names by which the Master was best known,
the Great Physician, is especially significant, for He was never known
to turn a deaf ear to the physically afflicted. The business world pushes
on, little heeding the fallen by the wayside, as the crowd surged by the
poor blind beggar and bade him hold his peace and trouble not the
Master; but as He heard the plea of Bartimeus, so will His followers,
the organized Christian forces, respond to the inarticulate appeal of
20,000 North Carolinians dying each year from preventable diseases,
and 40,000 of their neighbors needlessly bed-ridden for the entire year
from the same class of diseases.
A GROWING CHURCH AND A SICK PEOPLE.
The Bureau of the Census of the United States Government shows that
during the last fifty years there has been a steady and healthy growth
of the Christian Church, both in number of churches and value of
church property. The figures show that the church has, without a
single intermission, grown more rapidly than the population, and the
seating capacity with one single decennial decline which followed the
Civil "War, has been more rapid than the growth of the population.
The figures compiled from the Census Beport are as follows
:
4 BULLETIN N. C. BOARD OF HEALTH.
population in 1850 to 125 per hundred thousand in 1904. William E.
Kellicott, in his book, "The Social Direction of Human Evolution,"
says about these statistics of prisoners:
"Not all of this increase can be attributed to more rigid enforcement of the
law or raised standards of morality; there is sonic reason for thinking that
whatever change there has been in these respects has tended to have the
opposite effect. We should note, in considering such data as these, that the
penologist generally assumes that of the total number of offenders, actually
only about 10 per cent are in prison at any one time."
In the United States murders and homicides per hundred thousand
of the population have nearly trebled in the last fifteen years. Insanity
increased in the United States from 183 per hundred thousand of the
population in 1880 to 225 per hundred thousand in 1903. We have in
this civilized country, all told, approximately three million defective
people—insane, feeble-minded, blind, deaf, dumb, paupers, juvenile
delinquents, and criminals. That is to say, one person out of every
thirty of our population is defective. Take our country as a whole,
about 5 per cent of the population are at some time in their lives
dependent upon public charity; that is to say, that we have between
four or five million paupers in our country; and it is estimated by
sociologists of National repute that ten million of our population are
below the poverty line; that is, their physical efficiency is under par on
account of deficient food and poor clothing.
Divorce may be considered alongside of these other symptoms of
National diseases, because divorces disintegrate the very unit in the
structure of civilization. In the United States one out of every twelve
marriages results in divorce ; and this country, our blood-bought country
in which we have so much pride, has more divorces than all the rest of
the civilized world. In the State of Washington there is one divorce
in every four marriages ; in Montana one to five ; in Colorado, Texas,
Arkansas, and Indiana one to six; in California and Maine one in
seven; in New Hampshire, Missouri, and Kansas one in eight, and in
the city of San Francisco one in three. From 1867 to 18S6, twenty
years, the population of the United States increased 60 per cent
;
divorces 157 per cent. From 1887 to 1906, the next twenty years, the
population increased 50 per cent; the divorces 160 per cent. For 1905
the following statistics are available:
•United States 67,976 Great Britain and Ireland 821
Germany 11,147 Denmark 540
France ' 10,860 Sweden 448
Austria-Hungary 5,785 Norway 408
Switzerland 1.206 Australia 339
Belgium 901 New Zealand 126
Holland 900 Canada 33
Italy (1904) 859
•Quoted from "Sociology and Modern Social Problems," by Elhvood.
A well-known writer says
:
''Thus we are apparently within measurable distance of a time when, if
present tendencies continue, the family, as a permanent union between hus-band
and wife, lasting until death, shall cease to be. At least, it is safe to
say that in a population where one-half of all marriages will be terminated
BULLETIN ST. C. BOARD OF HEALTH. O
by divorce the social conditions would be no better than those in the Rome of
the decadence. We cannot imagine such a state of affairs without the exist-ence
alongside of it of widespread promiscuity, neglect of childhood, and
general social demoralization."
"What is the explanation of the apparent spiritual advancement coinci-dent
with moral and physical decline ? Ignorance ? Yes, of a kind, but
not the kind due to the lack of growth of educational work as con-ceived
by the teachers of the last thirty years, for the census shows that
there has been a continued decrease of illiteracy, from the time the first
census was taken in regard to illiteracy, in 1880, from 17 illiterates per
hundred population in 1880 to 13 illiterates per hundred in 1890 and
10 illiterates per hundred in 1900. There is a kind of knowledge, how-ever,
that the schools have not taught and that the race is sadly deficient
in, and it is undoubtedly responsible for much of the deterioration of
to-day. That all-important knowledge has to do with the laws of life,
the appreciation of the laws of heredity and of bad environment on the
functions of the human body. Our educational system in the past has
busied itself not too much with the development of the human mind,
but too little with the development of the human body.
Nor can we explain the array of facts above cited on a basis of
economic conditions. Here it is interesting to note that we have statis-tics
showing the growth of total wealth and per capita wealth in the
United States for the last fifty years. But our economic condition
depends not upon per capita wealth, but upon the distribution of wealth.
One man, or a few men, could own the entire wealth of the country
without changing in the least the per capita wealth; but the economic
situation that would result from such concentration of wealth would
profoundly influence the welfare of the race. And yet, with all the
noise the politicians are making about the concentration of wealth,
the United States Government, so far as we can ascertain—and we have
gone to the highest authorities, and a number of them—cannot state on
a basis of facts and figures anything regarding the distribution of
wealth in this country. The absence of such facts reflects upon our
system of government. However, I think we may safely conclude that
the economic situation in the United States has at least not deteriorated
during the last fifty years, and, in all probability, has much improved,
so that the symptoms of National diseases, above cited, would not be
ascribed to our economic conditions.
Communicable diseases, the only kind of diseases that Ave have to con-sider
from a public health viewpoint, depend upon the existence of
some common bond existing between those who become diseased. In
a small community or city, this bond of union exists in the nature of
some of the common utilities, such as schoolhouses, churches, postofficcs,
laundries, swarms of flies, etc. In larger collections of people tile only
bonds of union are customs, habits of thought, and ideals. These throe
things affect large bodies of people, and if the customs are improper,
the habits of thought bad, and their ideals not in accordance witli
natural (which is also divine) laws, then you may expect abnormalities
in the National life. The educational system of our country lias con-fessed
its sin already in the almost universal recognition among our
educational leaders of the importance of the physical in its relation to
6 BULLETIN N. C. BOARD OF HEALTH.
the mental. Medical inspection of schools is being adopted in all pro-gressive
communities, and the laws of hygiene and sanitation are being
taught in the public schools as never before. As this knowledge becomes
more widely disseminated the present race will take better care of itself,
will become more efficient physically, have better homes, think better
thoughts, and will be better morally. Again, let us remember, it takes
a good animal to make a good man.
Still we are lacking in the development of an appreciation of the
most important fact. in its relation to defects of all classes and crimes,
namely, the factor of heredity. The laws of heredity are just as much
laws of divine origin as the ten commandments, and no race can prosper
that disregards them. I give two concrete examples here, quoting from
"Social Direction of Human Evolution," by William E. Kellicott,
typical of the effect of these laws which Darwin had in mind long ago
when he wrote
:
". . . . except in the case of man himself, hardly any one is so ignorant
as to allow his worst animals to breed."
"One of the best known families of this type is the so-called "Jukes' family
of New York State, so carefully investigated by Dugdale. This family is
traced from the five daughters of a lazy and irresponsible fisherman, born
in 1720. In five generations this family numbered about 1.200 persons,
including nearly 200 who married into it. The histories of 540 of these are
well known and about 500 more are partly known. This family history was
easier to follow than are some others because there was very little marriage
with the foreign-born—'a distinctively American family.' Of these 1,200
idle, ignorant, lewd, vicious, pauper, diseased, imbecile, insane, and criminal
specimens of humanity, about 300 died in infancy. Of the remaining 000, 310
were professional paupers in almshouses a total of 2,300 years (at whose
expense?); 440 were physically wrecked by their own diseased wickedness:
more than half of the women were prostitutes; 130 were convicted criminals:
60 were habitual thieves: 7 were murderers. Not one had even a common
school education. Only 20 learned a trade, and 10 of these learned it in State
prison ! They have cost the State over a million and a quarter dollars, and
the cost is still going on. Who pays this bill? What right had an intelligent
and humane society to allow these poor unfortunates to be born into the kind
of lives they had to lead, not by choice, but by the disadvantage of birth?"
•'.... let us finally return to the other side of society and look at a
summarized statement of the Edwards family given by Boies and drawn from
Winship's account of the descendants of Jonathan Edwards. One thousand
three hundred and ninety-four of his descendants were identified in 1000.
of whom 295 were college graduates ; 13 presidents of our greatest colleges
;
55 professors in colleges, besides many principals of other important educa-tional
institutions; 60 physicians, many of whom were eminent; 100 and more
clergymen, missionaries, or theological professors; 75 were officers in the
army and navy ; 60 prominent authors and writers, by whom 135 books of
merit were written and published and 18 important periodicals edited; 33
American States and several foreign countries, and 92 American cities and
many foreign cities, have profited by the beneficent influence of their eminent
activity: 100 and more were lawyers, of whom one was our most eminent pro-fessor
of law: 30 were judges; SO held public offices, of whom 1 was Vice
President of the United States; 3 were United States Senators; several were
governors, members of Congress, f'ramers of State constitutions, mayors of
cities, and ministers to foreign courts; one was president of the Pacific Mail
Steamship Company; 15 railroads, many banks, insurance companies, and
large industrial enterprises have been indebted to their management. Almost
if not every department of social progress and of the public weal has felt
the impulse of this healthy and long-lived family. It is not known that any
one of them was ever convicted of crime."
BULLETIN N. C. BOARD OF HEALTH.
What we need in this country is greater stress on the importance of
the physical and if the churches will devote themselves a little more to
the "here" and a little less to the "hereafter" ; if preachers would give
more attention to the means, and possibly a little less attention to the
end, we believe that the evidence of the racial deterioration above cited,
which casts its shadow on a growing church, would be less noticeable.
THE PLACE OF THE PHYSICAL IN LIFE.
In the creation, according to Moses, the inorganic world, the vegetable
world, the lower animal world, and finally man were created, in the
order given. According to the same inspired writer, in the creation of
man himself, his physical parts were first formed, and to them the higher
mental and spiritual faculties were added. In the creation by evolution,,
the same order, from lower to higher form, takes place—from the worm
of the dust to a place a little lower than the angels. In embryonic or
prenatal development, the same order from the lower to the higher
obtains—the body framework, the heart, the blood vessels, the alimentary
organs, the nervous system, and of the last system, its higher part, the
mind, develops and continues its growth long after the other less highly
organized structures have reached their maturity. It is God's way,
according to both inspiration and nature, to make the physical a prelimi-nary
essential to the spiritual. From a public point of view, which sees
the average human being and not the exception, the truth of Herbert
Spencer's saying, that it takes a good animal to make a good man, is
fully realized.
WHAT THE COUNTIES ARE DOING.
LENOIR COUNTY.
The County Board of Health at their February meeting, under section
9, chapter 62, Public Laws of 1911, enacted several important regulations
for their county.
A regulation requiring the vaccination of all children attending the
public schools was adopted.
A regulation requiring the installation of sanitary privies of the type
suggested by the State Board of Health at all public schools was adopted.
A third progressive and commendable step was the following regula-tion:
"That no general drinking cup or dipper shall hereafter be allowed to be
attached to, maintained, or remain as a part of any public place for supplying
drinking-water within the limits of the county of Lenoir, including especially
all street fountains, pumps, and water-supply places for public schoolhouses
within said county or any city or town thereof."
So far as we know, Lenoir County is the first county in this State ro
take this step.
LEE COUNTY.
The following letter from Dr. J. P. Monroe, the County Superintend-ent
of Health, shows an active interest and definite progress in the health
work of Lee
:
8 BULLETIN N. C. BOARD OF HEALTH.
Db. W. s. k.\.m;i.\, Raleigh, V. C.
Dear Sir:—We held a meeting of rhe Board of Health yesterday instead
of the regular January meeting. It was decided to carry out the State law
relative to smallpox and not undertake the quarantine. The order issued last
year to the school board, to have sanitary privies built at each public school
building, was ordered to be carried out during the summer months. An unani-mous
request was made to the county commissioners that they build a county
home. It was ordered thai the commissioners contribute one-half and Jones-boro
and Sanford the other half of the necessary funds to secure Dr. Ferrell
for two weeks in the spring to give hookworm treatment. I feel sure that the
county commissioners ami the two towns will supply the necessary funds for
this treatment. Will write you as soon as I can get a hearing from them.
Yours fraternally.
(Signed) J. P. Monroe.
CUMBERLAND COUNTY.
The county commissioners have bought a site two and one-half miles
from Fayetteville for a new county home, the plans for which are now
being drawn. The county home will be thoroughly modern in construc-tion,
arrangement, and equipment. It will include suitable quarters for
treating tuberculosis, and will also be provided with wards where the
indigent sick of the county may be. cared for.
HAYWOOD COUNTY.
The County Board of Health, with the approval of the County Board
of Commissioners, have employed Dr. J. B. McCracken, their County
Superintendent of Health, to give two weeks of his entire time this fall
to speaking in different sections of the county on the subject of prevent-able
diseases.
We believe that Haywood is the first county to have taken such action
as this, and we commend her good example to other county boards of
health.
JOHNSTON COUNTY.
The County Board of Health, conjointly with the County Board of
Commissioners at the February meeting of the Board, passed resolutions
requiring the County Superintendent of Health to make quarterly
inspections of all the incorporated towns of the county. During the
inspection the health officer is to visit the schools, examine the sanitary
conditions of the schoolrooms and grounds, make medical inspection of
apparently physically defective children, and to report the results of
these inspections regularly to his County Board of Health. For these
services he is to be paid $4 per diem and 62V2 cents per mile, one way.
This is another important step in the right direction that other
counties can Avell pattern after.
MESSAGES FROM THE FRONT IN THE FIGHT AGAINST SMALLPOX.
Dr. D. A. Dees, County Superintendent of 'Health of Pamlico Count)/,
writes: "The posters sent me concerning smallpox have been thoroughly
distributed throughout the county. A great many people have been
vaccinated—negroes, even, applying for vaccination. I shall do all in
my power to make our present method of handling smallpox a success.
There are no more cases than we had when we had quarantine,
BULLETIN N". C. BOARD OF HEALTH. \)
and not one-half the trouble. Three places in the county have cases,
Oriental, Bayboro, and Vandemere. There has been more voluntary
vaccination than in all the epidemics we have had in former years.
Fortunately, we were able to keep the commissioners from establishing
quarantine. It is only a question of time, in my mind, when North'
Carolina will stay clear of smallpox if we keep the present law, and the
money we have spent in the past will be used for more important pur-poses
than in trying to protect those who will not protect themselves."
Dr. J. E. Malone, County Superintendent of Franklin County, writes:
"Your plan of education in the handling of smallpox is working well.
The people are sending for me to vaccinate them, and that is a good sign.
I have had our smallpox posters put up in different parts of the county
and I have ordered fresh points. The people begin to understand that
we are not going to quarantine, but vaccinate."
Dr. William S. Jordan, County Superintendent of Health of Cumber-land
County, writes: "From the clippings inclosed you will observe
that smallpox is to a great extent occupying the minds of our people
just at this time. They are arranged in the order in which they appeared
in the Fayetteville Observer.
"It is right amusing to note the nature of the comments in regard to
quarantine and realize that in no sense has the critic grasped the mean-ing
of abolishing the quarantine of smallpox in favor of vaccination, or,
rather, the meaning of the law, that by abolishing quarantine general
vaccination can be secured.
"During our present smallpox scare with no quarantine more than
1,500 people have been vaccinated in Fayetteville; whereas if we had
had quarantine I am satisfied there would not have been 200 vaccinated."
Dr. A. ' C. Bethune, County Superintendent of Health- of Moore
County, writes: "In the last thirty days I have had eighteen cases
| smallpox] in this county ; twelve cases near Elsie, three cases near
Pinehurst, and three cases in the neighborhood of Jackson Springs.
"From the three original cases brought into this county from Rocking-ham
I had more than a hundred exposures, but only fifteen new cases,
and these would not have occurred had patients been vaccinated in time.
"We have no quarantine regulations in this county for this disease,
but we are vaccinating a good many. In the last two weeks we have
vaccinated about three hundred people. I have been in the field every
day, and have gone from house to house explaining the object of vacci-nation,
and have met with splendid success. In the part of the county
where Ave have this infection we had an entirely unvaccinated population,
but they are interested and are offering themselves freely for vaccination.
We will likely order vaccination for the school children at an early date,
and in the meantime I am going from school to school and vaccinatinu'
all who offer."
THE McCULLERS CASE.
The McCullers case, recently decided in the Supreme Court of North
Carolina in favor of the plaintiff, Dr. J. J. L. McCullers, and againsl
the Wake County Commissioners, is important from a public health
10 BULLETIN N. C. BOARD OF HEALTH.
standpoint on account of the question of the State's interest and the
State's authority in county health work being seriously involved. The
opinion of the Supreme Court in this case, the position of the county
commissioners, and the bearing of the case upon the public health work
of the State, is published in this issue of The Bulletin. The contro-versy
between Mr. B. C. Beckwith, the County Attorney for Wake
County, who, of course, espouses the cause of the county commissioners,
and the Secretary of the State Board of Health, who defends the Wake
County Board of Health for its position in the McCullers case, and main-tains
the advantages of the control of county health work by nonpartisan
county board of health, is given in full in this Bulletin.
A WORD TO HIS HONOR THE MAYOR.
For His Own Sake, for His City's Health, and for His State's Good Name,
Please Read This: It May Pay You Handsomely.
The mayor of every municipality in North Carolina which has a popu-lation
of 500 or over, according to the 1910 census, is held responsible
by the State laws for the enforcement of chapter 722, Laws of 1909, as
amended by the General Assembly of 1911, which requires the registra-tion
of all deaths occurring in his jurisdiction according to the rules
prescribed under the aforesaid law. Section 5 of this chapter places his
Honor under a penalty of from $10 to $50 for the nonenforcement of
the law aforesaid. We respectfully request the careful reading of chap-ter
722, Laws of 1909, as amended by the General Assembly of 1911,
and especially of the 5th section of the said chapter.
SOMEBODY IN DANGER.
We know that some of the municipalities of North Carolina are not
registering all their deaths. We now have on -file in this office the abso-lute
proof of deaths which have occurred in several registration munici-palities
for which we have received no death certificates. In one munici-pality
we hold as many as ten unregistered deaths against the mayor.
Now, we are not going to name the several towns referred to ; this is
to notify the mayors of these towns that it will be to their interest to
have their local registrar review his work and to file certificates in this
office of deaths that are unregistered and of which the State has not as
yet taken official cognizance. "The thing for each mayor to do is to make
sure that his town or city is not one of those referred to.
Unless death certificates are filed in this office before the first day of
May, 1912, covering the known deaths which we hold and which are
unregistered, we shall appear before the first grand jury meeting in the
county in which these municipalities are located, and ask for indictment
of the mayor who is responsible for the violations of the State registra-tion
law. We are specifically commanded in section 3 of the aforesaid
State law to perform this disagreeable duty; and we shall not fail to
perform our duty because it is disagreeable. We sincerely hope that this
notice will serve as a warning and that the mayors of the registration
BULLETIN N. C. BOARD OF HEALTH. 11
municipalities of this State will have the work of their local registrar
reviewed, and, if unregistered deaths are found, to have death certificates
filled out for them and filed with us before May 1, 1912.
THE IMPORTANCE OF A VITAL STATISTICS LAW.
Do not allow yourself for a single moment to indulge the thought that
the value and the necessity of a vital statistics law cannot he established,
and easily established, with the average jury. Do not conceive the idea,
if you have never given the question of vital statistics any study, that
this law is a mere matter of form or "red tape." It is essential to the
health and the life of North Carolina people. This statement we can
and will make good in the courtroom.
If you would appreciate the importance of this law, ask yourself how
you would go about ascertaining the health of a town or community or
State. Would you write some citizen of the place in which you were
interested, and ask his opinion? Could you expect anything but a
favorable opinion from one whose material advancement depended upon
your favorable opinion in regard to the advantages of buying property
in his city ? What you would do, would be to write to the United States
Bureau of the Census or to your State Board of Health and find out
the average death rate from all causes and for certain diseases through-out
the United States, secure comparative data from the town whose
health conditions you are interested in, and by comparing the two, see
exactly how the health conditions of the town in question compared with
the average. Vital statistics are the means, and the sole means, of detect-ing
the symptoms of a sick community or town. Take them away or
make them inaccurate, and the sanitarian has nothing to guide him
in recognizing disease politic, and certainly he cannot treat that which
he cannot recognize. In short, vital statistics are to public health work
what the symptoms of a disease are to the individual practitioner.
When they are incomplete they give the impression of a healthy town
when a sick town exists, and should be treated, with the ultimate effect
of saving many human lives. Incomplete statistics are misleading; it
is better not to be led at all than to be misled.
Not only do incomplete vital statistics place the mayor under penalty
for violations of this law, and make it impossible to recognize and
improve health conditions in his municipality, that is, to save the lives
of his constituency, but these incomplete statistics endanger the standing
of his State in the estimation of the civilized world. Most civilized
countries, 60 per cent of the United States, including most of the
Northern States and the progressive Western States, take official cogni-zance
of and record the two principal events in the lives of their citi-zens—
birth and death. Nonregistration of births has frequently resulted
in the failure of a child to inherit the property to -which it should have
been heir, in its being placed in industrial plants under age, in its failure
to obtain insurance or the right to exercise its suffrage. Nonregistration
of deaths has not only a profound bearing on the general welfare of
people from a sanitary point of view, but is important from a legal
standpoint, frequently making unnecessary exhumations, and exhuma-tions
which in most cases are valueless as evidence on account of
advanced decomposition of the deceased.
12 BULLETIN N. C. BOARD OF HEALTH.
The United States Census has examined the registration of deaths in
North Carolina and has satisfied itself that the registration law of North
Carolina is so incompletely enforced in about twenty of the municipali-ties
of the State that the figures of North Carolina are misleading and
cannot be accepted by the United States Government. This means, of
course, that the outside world will not accept the registration statistics
from North Carolina when our own National Government cannot accept
them. . . .
The mayor who is not requiring a complete registration of deaths in
his town or city is in this way denying a proper standing to his State
among the civilized countries of the world.
Now, his Honor can enforce this law. If he thinks he can't, let him
read it ; and, then, if he thinks he can't, let him recall that it is being
enforced for 60 per cent of the population of the United States; that
its enforcement has proved to be practicable. And, in conclusion, let me
assure any mayor who doubts that this law can be enforced, that the
State Health Officer, although a comparative stranger in his town, can,
through an examination of the newspaper files of his town or city paper,
through interviews with hardware dealers who sell coffins, doctors, ceme-tery
keepers, and preachers, easily discover unregistered deaths if the
law has not been properly enforced. And if Ave can do it, his Honor
certainly can do it.
A last word : Unless you are positively sure that your city is not one
of those against which we hold the proof of unregistered deaths, which
places you under a penalty of from $10 to $50 for each unregistered
death, we respectfully request that you confer with your local registrar,
the undertakers, the physicians of your acquaintance, and make sure
that this law is enforced and that there is no danger of the grand jury
hearing charges against you at the next term of your county court.
"We issue this warning and make this request to save both yourself
and us disagreeable court, proceedings.
THE SIXTH COMMANDMENT AND ITS INTERPRETATION.
Hexry Louis Smith, Ph.D., M.D., President Davidson College; Contributing Editor of The Bulletin.
Of all the history-making creeds and confessions of the religious
world, probably none was compiled with such exceeding care, or has so
profoundly influenced the history and development of the English-speak-ing
races as the Standards formulated by the Westminster Assembly of
Divines about 265 years ago. These Standards embodied in clear and
condensed form the Puritan-Presbyterian interpretation of the Scrip-tures
as a systematic whole, touching life and doctrine at every point.
The great Assembly spent five and a half years on its work, and held
over 1,100 sittings. The immortal Shorter Catechism of this Assembly
condenses the whole into a few pages, giving an epitome of the whole
Calvinistic system.
The exposition of the sixth commandment therein contained employs
less than two score words, yet it sweeps the whole gamut of modern sani-
BULLETIN N. C. BOARD OF HEALTH. 13
tation, community uplift, organized cleanliness, medical care of neglected
children, and preventive medicine in all its varied aspects. After the
statement that the sixth commandment is, "Thou shalt not kill," follow
two questions, constituting the 68th and 69th of the Catechism. The
68th, "What is required in the sixth commandment?" Answer: "The
sixth commandment requireth all lawful endeavors to preserve our own
life and the life of others." 69 : "What is forbidden in the sixth com-mandment?"
Answer: "The sixth commandment forbiddeth the taking
away of our own life, or the life of our neighbor unjustly, or wliatsoever
tendeth thereunto."
When we remember that this interpretation of the sixth commandment
was wrought out nearly three centuries ago, before the modern science
of sanitation and preventive medicine was heard of, we are astonished
at its perspicacity, its breadth, and its up-to-dateness. We stand amazed
that the Church has thundered against the violent taking away of human
life, yet has so rarely recognized that the divine obligation imposed by
the commandment extends to the conserving of human life by warding
off all preventable diseases, and that the divine imperative forbids all
practices, modes of living, and methods of conducting business, that
needlessly endanger the health of those thus employed.
To the philosophic mind, our bondage to the gross, the palpable, and
the spectacular is almost inconceivable. When a fair-haired little girl
is ruthlessly murdered with an axe or a bludgeon, the whole Nation
grows hysterical in a frenzy of indignation ; yet, perhaps, on that very
day families are moving all their earthly belongings into tenement,
houses made vacant by tuberculosis, and our communities watch the pro-cession
to the graveyard begin again without a word of protest.
When a tenement house catches fire, and in spite of the valor of the
firemen and the sympathy of thousands of spectators, some of its inmates
perish in the flames for lack of fire-escapes, the whole land grows
righteously indignant, and the owner of the building is probably prose-cuted
for murder. Yet the general public allows the filth and unsanitary
condition of such a building to doom a large percentage of its inmates
to death every year without a lawsuit or a word of protest.
If a dweller in one of our cities kept a ferocious wolf on his premises,
and his captive, through the carelessness of its owner, should escape and
tear a citizen to pieces on the public highway, the whole city would be
in a white heat of righteous indignation. It endures, however, without
realization or protest, the breeding of flies and mosquitoes in countless
millions on premises whose owner can easily abolish such breeding places
if he desires, but is too lazy or careless or avaricious to do so. Yet it is
undoubtedly true that these insects destroy the lives of more people in
any one State, in one year, than all the wild beasts and mad dogs of the
United States have destroyed since the settlement of our country.
Our greatest Teacher, twice himself, taught us how to interpret and
apply these marvelous ten Words of the Law. FolloAving His example,
we must believe that the prevention of diseases is as clearly enjoined by
the sixth commandment as the prevention of actual murder, and thus
every such effort has a religious sanction and is a religious duty. Minis-ters,
therefore, can and should pi*each on the whole meaning of the sixth
commandment, as on the whole meaning of the other nine, enjoining the
care of our lives and the lives of others as a religious duty.
14 BULLETIN IT. C. BOARD OF HEALTH.
THE MODERN APPLICATION OF THE PARABLE OF THE
GOOD SAMARITAN.
\V. P. Few, Ph.D., President of Trinity College; Contributing Editor of The Bulletin.
I do not know that a text could be found better suited for a sermon on
Sanitary Sunday than the parable of the Good Samaritan, enforcing as
it does so powerfully and beautifully the human duty of neighborliness
and care for the sick.
_
Modern civilization rises or falls just in proportion as it embodies m
itself the principles included in what the New Testament calls the King-dom
of God, that is, that reign of ultimate truth which Jesus Christ
came to set up in the lives and characters of men.
While this truth may be called ultimate in its finality, it is not given
to us in the shape of a formulated philosophy of life. It is germinal in
its character. It is to be interpreted and applied to all phases of our
life and conduct. This parable, for example, has nothing to say specifi-cally
about preventive medicine, sanitation, or hospitals; still it holds
in solution the whole doctrine of care for the sick and needy. The ideas
we are left to work out for ourselves ; that is the field of modern science
and that has been a chief discipline of the race. But it does lay upon us
the Christian duty of using the best wisdom of this generation and of
all generations not ony in tending the sick, but especially in making the
conditions of life wholesome and uplifting, and so preventing sickness.
If it is a duty to help the sick, it is an even higher duty to_ prevent
sickness so far as that lies within the power of a well-ordered civilization.
If we rely on Providence to take care of us when we ourselves do not use
all the means within our reach, we are merely sinning against the light.
Ideas, as opposed to germinal truth, are the outgrowth of advancing
civilization, and new ideas are constantly needed when changed condi-tions
arise. Hence the necessity for constant progress, else there must
be sure decay. The crowded conditions of modern life in cities and
densely populated districts make necessary new methods for preventing
the spread of disease; otherwise the health and welfare of the whole
people are placed in jeopardy. So comes about the duty for communities
and States not merely to care for the sick individual, but to create condi-tions
that will make for the health and happiness of the whole people.
And this, I think, is doing nothing more than giving a wide application
to the parable of the Good Samaritan.
To lay properly the physical foundations of life is a stupendous task
to which the race had scarcely begun to set itself. The marvelous
achievements in material progress and widespread physical well-being
within the past fifty years have made it possible for large numbers to live
comfortably and even sumptuously with the body. The attainments of
the recent past are, no doubt, but a faint foreshadowing of whatis to
follow in the long and upward march of the human race. And in all
the efforts of religion and education and civilization to keep and trans-mit
the precious heritage of humanity, one of their first tasks is this
conservation, strengthening, and sweetening of human life itself.
"He hath anointed me to preach the gospel to the poor; he hath sent
me to heal the broken-hearted; to preach deliverance to the captives, and
BULLETIN N. C. BOAKD OF HEALTH. 15
recovering of sight to the blind ; to set at liberty them that are bruised."
In these words from the ancient prophet, Jesus Christ at the outset of
His earthly career announced His mission to free and expand all the
powers and all the capacities of our human nature. It is a prophecy of
a completely redeemed humanity, and the splendid vision will become a
reality when the bodies, the minds, and the characters of men are cared
for as they should be, on a vast and universal scale.
PUBLIC HEALTH PROGRAM FOR PREACHERS.
William Louis Poteat, LL.D., President Wake Forest College; Contributing1 Editor of The. Bulletin.
The preachers of North Carolina are so intelligent a body of men and
are so alert in their consecrated service to the community that it would
seem almost an impertinence to make suggestions to them about their
opportunities respecting the public health. I venture, however, upon
the request of the Secretary of the Board of Health, to offer for their
consideration the following program of activities
:
I. Form and inform the local public opinion by at least one sermon
on public health. Texts : "He wrent about doing good." Acts x :38. "All
they that had any sick with divers diseases brought them unto him;
and he laid his hands on every one of them and healed them." Luke
iv :40.
Two leading ideas
:
1. The distinctively practical aim of Jesus' teaching and work.
2. The large part of His public ministry devoted to curing the sick.
II. Help in finding practical expression of the informed public opin-ion
on public health
:
1. Cooperate with local physicians. Attend meetings of the county
medical society.
2. Distribute, Avith the same motive and fidelity as in the case of
religious tracts, the bulletins and other publications of the State Board
of Health.
3. Organize clean-up leagues and sanitary clubs, enlisting the interest
of the women of the community.
WASTE. 1
fBy Cyrus Thompson, M.D., Jacksonville, N. C.
If the art of living is the finest of all the fine arts—and who that
dreams of a perfect life shall doubt it?—then the saddest thing in life
is man's slowness in learning to live it. The world is so beautiful, so
beneficent, so abundant. The order of nature is so frugal and so con-
*Annual oration delivered before the Seaboard Medical Association of Virginia and North Caro-lina,
at Newport News, Va., December 5, 1911, and first published in The Virginia Medical Semi-
Monthly.
tDr. Thompson is a Contributing Editor of The Bulletin.
16 BULLETIN N. C. BOARD OF HEALTH.
servative. In the stars of the firmament, there is no lost motion ; no
planet swerves from its helpful path; there is no dissipation of energy
but is conserved in some useful form. If human economy is negligent,
destructive, and wasteful, the divine order is constructive and saving.
Out of the void and darkness, the spirit of God created all that is, pre-serves
it all, and destroys nothing. Out of the abundance of man's her-itage,
over which he holds rightful dominion, behold the waste of life,
the waste of opportunity, the stupendous waste of material
!
Just one old Book contains the wisdom of the ages—written by the
best of their times about the best when at their best. As a scheme of
life the world's literature has nothing comparable to it. It makes record
of the one perfect life, the one universal man, the measure of all men.
In Palestine one afternoon, this Galilean had been teaching a vast
multitude. "When the day began to wear away, then came the twelve
and said unto him, 'Send the multitude away, that they may go into the
towns and country round about, and lodge and get victuals; for we are
in a desert place.' But he said unto them, 'Give ye them to eat.' And
they said, 'We have no more but five loaves and two fishes, except we
should go and buy meat for all this people.' For they were about five
thousand men. And he said to his disciples, 'Make them sit down.'
Then he took the five loaves and tw^o fishe3, and looking up to heaven
he blessed and brake and gave to the disciples to set before the multi-tude.
And they did eat and were all filled." "When they were filled"
—
with food and no less -with wonder—when the multitude and the disciples
of the Master were satisfied and ready to go away, then came to his
disciples this command out of the carefulnesss of God, "Gather up the
fragments that remain, that nothing be lost." A desert place, to be
sure—a multitude to be fed, only five loaves and two fishes ; but the Lord
of Life, the master of the feast, the divine economy of saving, and the
fragments more than they had at the beginning
!
With the savage man, all is waste ; as civilization advances, something
is saved, though much is lost.
In a material way, we are saving much. The cotton of the South not
long ago was valuable only for the lint, but now a very considerable
part of the value of the crop is contained in the seed. Thirty years ago,
a seedless lint seemed desirable ; to-day the cotton-grower would almost
welcome a lintless seed. Olives do not grow in the cotton belt, nor cows
and hogs on cotton stalks; but from cotton seed we get lard made in
Chicago, butter churned in Indiana, and olive oil pressed in sunny Italy.
Petroleum gives us everything from axle-grease for an ox-cart to gaso-line
for. an aeroplane; and the profits of the Standard Oil Company are
largely made from the waste of twenty-five years ago. Armour has
learned the saving principle of the whole hog or none; and he puts on
the market everything from the ham to the internal secretion of the
suprarenal gland. It used to be a problem with our sawmills what to
do with the sawdust. Invention found a way to throw it into the furnace
for fuel, and later invention converts it into vood alcohol. On farm
and in factory, improved implements, methods, and machinery make
impossible and ridiculous the slow and wasteful methods of other days.
Vast areas of waste lands we are reclaiming by drainage, and by irriga-tion
we are forcing the desert places to blossom like the rose. The stage-
BULLETIN N. C. BOARD OF HEALTH.
coach is a memory, and railroads are everywhere ; and the wastefulness
of bad country roads is preached at every turn by the makers of auto-mobiles
and gasoline. The Avaste power of turbulent waters is converted
into productive energy. Steam and electricity, the telegraph and tele-phone,
are crowding the world together and wiping out time and dis-tance
; and still, finding it too far withal to steam around Cape Horn,
we are spending our millions to save time, and cut across at Panama.
And in a social way, we are becoming conscious of our wastefulness,
and are turning our minds to the principles that underlie conservation.
I believe that I am right when I say that all social waste is due to the
assertion of individual rights, and all social conservation is founded
upon a denial of them. And I believe that the best government for any
man is that which is best suited to develop the best possibilities that are
in him. The form of government, in other words, must be determined
by the matter of development.
All government is a denial of natural rights and the substitution of
duties for the good of the individual in the common good. The fullest
exercise of natural rights is found in a state of savagery ; the highest con-servation
of rights is found in a state of civilization—in that civilization
which makes fullest denial of natural rights for the well-being of society.
The State exists for the individual, and the individual must exist and
be fitted to exist for the State. Xo personal right can stand in the way
of the individual and social good. The doctrine of rights must yield to
the doctrine of duty; in the higher civilization, the sense of selfishness
must give place to the sense of service.
The law of eminent domain holds true not only in lands and material
things; it is operative as well over men. The State may tax for the
preservation of order and compel for the public service. It may fine
and imprison for crime; for the safety of society, it may take away all
rights for a time or a lifetime; nay, it may take even life itself when
the individual so misuses his rights that his death, better than his life,
subserves the public good.
Preventive medicine, than which there is no finer fruit of civilization,
is founded upon a denial of rights. Compulsory vaccination is primarily
for the safety of the individual, but mainly for public protection. Quar-antine
against acute contagious and communicable diseases is prevention
of waste through denial of personal rights. We may not allow a man to
exercise a right when he exercises it to his own hurt and to the injury of
his neighbors. The right is taken from him for his own and the public
good, so to conserve best his best rights in the health of his community.
These principles we are steadily educating men to appreciate, and
when we come to the full appreciation of the divine economy of service
and saving, pestilence will not walk in darkness, nor destruction waste
at noonday.
A dairyman's cows are his own, to be sure; but he may not sell inf<
milk to waste the health and life of his neighbors' children.
A butcher's meat is his own; but, if unfit for human food, he may not
offer it in the market-places.
A patent nostrum is its maker's own; but let him warn the purchaser
of its narcotic content.
18 BULLETIN N. C. BOARD OF HEALTH.
A manufacturer's money is his own; but he may not spend it for the
cheaper labor of the undeveloped child, or require of a man for a day's
labor toil beyond a definite number of hours.
A man's child is his own ; but he may not waste its growth and health
and life in hazardous labors.
A man may not waste his own child nor his neighbor's child, nor
claim any right of person or property that hinders the aggregate develop-ment
and safety of his community.
On every hand out of the mouths of frauds, ignorance, and politicians,
we hear enough of the rights of men; let us hear more rather of their
duties. We have had enough of waste; it is time we had more of con-servation.
To love our neighbor as ourself is but to see ourself in our
neighbor and to find our safety everlastingly involved in his welfare.
From rights, then, to duties ; so leads the way from waste to permanent
wealth and happiness.
Think for a moment of the stupendous waste in an uneducated and
untrained child, the countless untrained, undeveloped, uneducated chil-dren
of the past. You desire wealth, but intrinsic value resides only in
man; the value of things is derived from man; and the greater or less
value of things is dependent upon the character, the quality of man. A
lively consciousness of this fact is the motive of all progress in education.
Our system of public education is founded upon a denial of rights and
a material consciousness of duties—a denial of the right of the child to
himself, of the right of the parent to his child, of the right of even the
childless man to so much of his money as may be necessary for the
child's education. To conserve, to construct, this is the mark and work
of civilization ; to tear down, to hinder, let that be of the past : it is
diabolical. To build, to prevent waste, this embodies the whole duty of
civilized man. The State is endeavoring to build for the sake of the
individual and itself, and the individual must not be permitted to hinder
or destroy, not even for himself. The State is fulfilling its duty to the
individual, and the individual must be fitted to fulfil his duty to the State.
To prevent waste, therefore, we have everywhere our common schools,
our graded schools, our colleges and universities; our technical schools
for the education of men and our normals for the training of women.
For the same reason we shall come everywhere to a system of compulsory
education. Kecognizing already the defects and consequent waste of our
methods, we are coming even now to the study of exceptional and nervous
children and to the medical inspection of school children in general.
To prevent waste, the State, the churches, and fraternal orders estab-lish
and maintain orphanages. These are not mere charities, not matters
of sentiment only ; they are makers of men and women—they make them,
alas ! far better than the average home
!
To prevent waste, we teach the deaf and dumb and the blind, and
make them self-sustaining members of society.
To prevent waste, we care for the insane and the epileptic, and restore
many of these unfortunates to happy and useful life.
To prevent waste, gathering up hitherto neglected fragments, the
State of North Carolina leads among Southern States in the establish-ment
of a school for the teaching of the feeble-minded. The motive
originated in this society, and stands as one of its glories forever. The
BULLETIN N. C. BOARD OF HEALTH. 19
Commonwealth of Virginia is urged to follow in this constructive work;
and Virginia cannot lag behind.
To prevent waste, everywhere there is better care of the criminal
classes. The old misanthropy did not seek to reform and save ; the old
misanthropy imprisoned in noisome jails without hope of health or
reformation, at the offender's cost and wretchedness. No prouder name
stands in English history than the name of John Howard, the humane
country gentleman, high sheriff of Bedfordshire, the father of modern
prison reform. Begun in sentiments of humanity, the new philanthropy
leads the State to take account of the offender and forces the offender to
take account of the State. We punish the criminal not for the sole pur-pose
of punishing, but for the protection and progress of society, to deter
others from the commission of crime and to reform or improve the
offender and send him home a useful member of society. If we deprive
him of liberty and his rights, it is to make of him a better citizen. We
work him and care for him ; we feed him, clothe and shelter him ; we make
him profitable to himself and useful to the State even against his will.
To prevent waste, we have juvenile courts that consider the defects
and possibilities of the criminal ; and we build reformatories for young
criminals, lest the hope of reformation to useful life be lost by associ-ation
with the irretrievably bad.
To prevent waste, the physician has ceased to be the mere giver of
drugs to them that are sick ; he is become the peripatetic teacher of sani-tation
and hygiene, the guardian of individual and public, the apostle
of the gospel of health. Having fought against death at close quarters
and failed, he warns all men everywhere to fortify against his approach.
And so he adds to the years of human life. If he carries no more of us
beyond the limit of three score years and ten, he leads more lives more
nearly to this limit. Oh ! the waste of life in its prime, the slaughter
of the innocents from mothers' arms, the untimely tears of broken hearts,
before the physician glimpsed the fulness of his mission and began to
rouse the State to the duty of preventive medicine! You've seen the
tumorous scars, in every city, hamlet, and churchyard, that made pre-maturely
leprous the beautiful face of mother earth.
Not that our work is yet fully comprehended or perfected ; but this
one thing we do, forgetting the things that are behind, we press forward,
proud that on stepping-stones of our dead selves we are rising with better
conscience to higher things.
To prevent waste, the manufacturer begins to look after the sanitation
of premises and the health of his operatives. He finds that he can save
life and time and money.
To prevent waste, great insurance corporations are organizing health
departments, issuing health bulletins, and teaching their policyholders
and the public how to live.
And to prevent the waste of war, this relic of barbarism, this verity of
hell—the dream of poet and seer through centuries from Isaiah to the
latest soul that sang in sight of things—to beat our swords into plough-sliares
and our spears into pruning-hooks—the greater nations of the
earth now seek to adjust their disputes by arbitration. May our young
Nation lead the world in this joyous laugh in the face of Death! Oh,
it will come some time, and nations will learn war no more ! Did you
20 BULLETIN N. C. BOAKD OF HEALTH.
ask when? I know not the day; but when man is wise enough to exer-cise
his duty to his fellow as he would now assert his rights in his face,
we shall not be far from the
"One far-off divine event,
Toward which the whole creation moves."
For the world, despite all its evil and waste, is growing better; but
from wild grapes to grapes is a long way, a slow and halting evolution.
But there is more of high ideal and noble purpose in the world than
ever before; knowledge is being diffused as never before, and we are
growing more humane. But if we are on the Appian way, in sight of
the Three Taverns, let us thank God, take courage, and go on : we are
not yet in Rome.
For with all our diffusion of knowledge and increase of humane senti-ment,
with all that we write on our ledger as profit, is there not some-what
that we must set down as loss? "Reaching out for more things
that are good, are we holding fast to the best things that we had?" The
fear of hell may be the hangman's whip to hold the wretch in order ; but
the fear of hell, the fear of punishment, is a necessary adjunct of govern-ment.
The soul that sinneth, it shall die : let that law stand ! For the
wretch, the wrong, the wrong in moral fiber, punishment must be swift
and sure. But on every hand, crime goes unpunished and murder is
unavenged; mobs lynch and set the law at naught. In one turbulent
Commonwealth, even the Governor, the Chief Executive and embodi-ment
of law, condoned a lynching and expressed his willingness to have
resigned his office and led the mob in his own State.
We are losing the fear of punishment both here and hereafter. In
some serious sense, society is letting the sentiment of humanity run pre-maturely
to seed. Our sympathy with the criminal living makes us for-getful
of the murdered dead ; juries listen to sham pleas of insanity, and
courts seriously ponder over the violence of brainstorms. We are too
humane to convict on circumstantial evidence, the only evidence without
possible motive to lie. To withhold lawful punishment from this brood
is to expose the innocent and endanger society; to punish with certainty
is to protect society, lessen insanity and cool the heads of the violent.
To be commended are the courts of Virginia : Beattie said at last that
circumstances had not lied on him; and McCue's insanity did not lessen
his crime or the consequence of it.
So with all our increase of knowledge and growth of humane senti-ment,
our utilization of natural resources and prevention of material
waste, our marvelous National progress, the thoughtful man cannot fail
to inquire if we are building character, making men and women, as well
as we builded in former days. After all, are we not tithing mint and
anise and cummin and forgetting the weightier matters of the law? Are
we as law-abiding as we used to be ; have we the old-time reverence for
sacred things; do we reverence God and the State as our conscience, and
our conscience as the State and God ? By the assertion of rights, are we
not following the way of the prodigal who spent his substance in riotous
living and would fain, at last, have filled his belly with the husks which
the swine did eat ?
BULLETIN N. C. BOARD OF HEALTH. 21
If my son have not respect for my authority and the authority of the
State ; if he reverence not God and holy things ; if he have not faith and
hope and love abiding in him ; if he have not respect for the rights of
others and respect for himself; if he have not character; no wealth or
knowledge of his can tell me that he is not a dangerous derelict without
anchor, and I shall know that he is the heaviness of his father.
I am not preaching you a sermon—I am not cut out for that—hut
whatever of good there is in me comes, I know, from that mature senti-ment
which, when the Sabbath dawns for man's rest, says "Come, let us
go up unto the house of the Lord" ; and, when I have entered, "The Lord
is in his holy temple ; let all the earth keep silence before him !"
Rights and not duties, selfishness and not service—that all men are
created free and equal, that every man is born an uncrowned king—here
is our leakage ; and we go to wreck upon the rock that all just powers of
government are derived from the consent of the governed. It is not true.
Our wilder western commonwealths are eating and offering us the tooth-some
apple of the initiative, the referendum and the recall, even of
judges. For authority, law, order, under which alone abiding progress
is possible, they would substitute the shifting whim of the multitude
;
for obedience and stability they offer us emotion ; for progress, the mere
turbulence of change. In the midst of it all, one feels like crying out
—
"Ah, God, for a man with heart, head, hand.
Like some of the simple great ones gone
Forever and ever by;
One still strong man in a blatant land,
Whatever they call him—what care I?
Aristocrat, democrat, autocrat—one
Who can rule and dare not lie
!"
That all governments derive their just powers from the consent of the
governed—it is not true. But this is time, that even a king must be a
king, not for himself, but for his subjects. Until your uncrowned kings
are developed to comprehend this in themselves, the just power of govern-ment,
even for the sake of the development and safety of your uncrowned
king himself, is founded in the duty which the greater man owes to the
less. We governed Cuba till she was capable of self-government. We
shall govern the Philippines till they are capable of self-government ; it
is our duty to them, and we do not ask their consent. We govern and
care for the disfranchised negro in the South; the wiser of their race
know that it is best. It is a matter of duty, not a question of consent.
One thing more. Whether there be startling political fads and graft
in places low and high; maudlin sentiment for the criminal and slack
enforcement of law; if we grow pessimistic and deplore the decadence of
morals on every hand; if the moral stand aghast at the abundant grist
of divorce mills; know that these things originate in one common source,
the most appalling source of social waste, the increasing laxity of family
government. This is the one most baleful instance of assertion of rights
and negation of duties.
It used to be said that the parent controlled the child; it is now a
common saying that the child controls the parent. That the parent does
not control the child is too grievously true. Parental authority in no
22 BULLETIN N. C. BOARD OF HEALTH.
sense depends upon the consent of the governed. It is inherent in parent-hood;
it is a duty which the parent has no right to disregard, whether
for himself, for his child, or the State. For the family is the indispen-sable
social unit. The purpose of the family is the training of children
to orderly life and citizenship. More and more the family is failing of
its purpose. I must train my child in the way he should go for the
child's sake and for society's sake. It is not a work which I have a
right to do or not to do : it is my inalienable duty to him, to the State,
and to God. I may not relinquish my work any more than the
Creator of all things may abdicate His throne upon the circle of the
heavens. So only can come among men the doing of justice and judg-ment.
The Puritan may have been unduly austere, but the Puritan
made men and women. To spare the rod even and so spoil the child,
what is it but to take out of my child the best that is in him along with
all his best possibilities? I, his king, will have robbed my subject and
wasted the substance of the State.
Patriot and demagogue rant about rights of local self-government
let them descant less upon the beauties of it to the thoughtless, unbridled
multitude; but rather, as fathers, let them teach it to their children
—
teach them obedience to divinely constituted authority and obedience to
self. For "he that ruleth his spirit is better than he that taketh a city."
So may crime be lessened and more surely punished ; so may juries look
up to God and care well for the State ; these new mad-storms of reckless
brains be lulled ere they rise ; the company of the insane will grow
smaller, and the number of hysteric women and psychasthenic men will
grow less.
In the building of character, the right attitude of the soul of man, a
work of early years, nothing can take the place of the family. The
schools are only supplementary. And I pray you, O schoolmaster, teach
my child both obedience and books if you can ; but if you can teach him
no books, teach him obedience to you and control of himself—teach him
this form of local self-government, this most vital, embryonic form of
democracy.
It is said that "when the court chaplain of Frederick the Great was
asked by that gruff monarch for a concise summary of the argument in
support of the truths of Scripture, he instantly replied, with a force to
which nothing could be added : 'The Jews, your Majesty, the Jews !' "
a people enduring, law-abiding, not much given to crime.
"And the Lord said, Shall I withhold from Abraham that thing Avhich
I do, seeing that Abraham shall surely become a great and mighty nation,
and all the nations of the earth shall be blessed in him? For I know him,
that he will command his children and his household after him, and they
shall keep the ways of the Lord, to do justice and judgment, that the
Lord may bring upon Abraham that thing which he hath spoken of him."
It would come in no other way; not even the Lord could bring it any
other way
!
Therefore, whoso shall rouse the heads of American families to resume
their divinely rightful sway, to discharge to their children, the State,
and to God their inalienable duty, he shall preserve our rights and pre-vent
the waste of the Nation.
BULLETIN N. C. BOARD OF HEALTH. 23
*FULL TEXT OF OPINION IN THE McCULLERS CASE.
In view of the fact that the opinion of the Supreme Court in the mat-ter
of Dr. J. J. L. McCullers v. "Wake County Commissioners affects the
entire State, The Times is printing the opinion in full to-day:
No. 217—Wake.
In the Supreme Court of North Carolina,
February Term, 1912.
J. J. L. McCULLERS, APPELLANT, v. THE BOARD OF COMMISSIONERS
OF WAKE COUNTY, N. C.
This is a proceeding for mandamus to compel the defendant board to admit
plaintiff to the office of superintendent of health of Wake County, and to
compel the said board to audit his accounts for services.
The cause was heard by his Honor. Judge Peebles, in the Superior Court of
Wake County on December 1, 1911, and judgment rendered denying the relief
prayed and dismissing the proceedings.
From the said judgment plaintiff appealed.
Aycock & Winston and Bart M. Gatliiu/ for plaintiff
B. C. Becktcith and R. N. Simms for defendant.
Brown. J. The plaintiff derives his title to the office of superintendent of
health of Wake County by appointment of the secretary of the State Board of
Health, under chapter (32, sec. 9, Public Laws of 1911, which provides that if
the county board of health of any county shall fail to elect a county superin-tendent
of health within two calendar months of the time fixed by the statute
when such election shall take place, the said secretary of the State board
shall appoint.
The defendant board of commissioners passed a resolution undertaking to
appoint a superintendent of health and to fix his salary. In consequence of
such conflict between the two boards and the failure to fix his compensation,
the plaintiff appeared before the board of health at its next meeting and
declined to qualify as superintendent of health for Wake County. The board
of health having failed to elect a superintendent for more than two calendar
months, the secretary of the State board, W. S. Rankin, on July 17, 1911,
appointed plaintiff the superintendent of health and quarantine officer for
Wake County, and fixed his fees and compensation, claiming to have done so in
accordance with sections 9 and 16 of said act. The plaintiff qualified as such
and the defendant board declined to recognize him and to pass on. audit and
approve his bills for fees as required by section 9. His Honor found the facts
as stated in sections 1 to 8, inclusive, of the complaint to be true, but it is
unnecessary to state them more fully.
1. It is contended that the contingency had not arisen when the secretary
could lawfully appoint. The statute requires the board of health to meet and
elect on the second Monday in May, 1911. and thereafter on the second Monday
of January in the odd years of the calendar. A majority of the board of
health voted for plaintiff, but he refused to qualify. It was the duty of said
board to at once elect another person. This it failed to do. so that the office
remained vacant for more than two months up to the time the State secretary
made the appointment. We think the true intent and meaning of the statute
is to give such appointment to the State secretary when the board of health
for any reason permits the office to remain vacant for two calendar months
trmn the date fixed by the statute, in this case the second .Monday in .May.
The public iuterest requires that this particular office shall have an incum-bent
to discharge its duties, and the evident intention of the General Assembly
was to prevent the office being unfilled for a longer period than the time named.
We think the learned counsel for the defendants place a too restricted con-
*Raleigh Evening Times, February 22, 1912.
24 • BULLETIN N. C. BOARD OF HEALTH.
struction upon the meaning and purport of the words, "shall fail to elect," as
used in the statute. We think the General Assembly meant the choosing and
induction into office of a superintendent of health within the two calendar
months. State v. Wilroy, 10 Ire., 329. If this were not so, then a hostile
board of health could keep the office vacant by electing a person who would
not qualify, and the purpose of the General Assembly be entirely defeated.
2. But the real controversy in this case, which has been argued with much
force by counsel on both sides, is the constitutionality of section 9 of the act.
The power of the secretary of the State board to make the appointment is
conferred by said section, and if it is void in toto, then it is contended that
plaintiffs title to the office fails. The learned judge of the Superior Court
rook this view and in his judgment expressed it in these words:
"Article 14, sec. 7, of State Constitution, forbids the holding of two offices
by one man at the same time. If the act had provided that D. T. Johnson,
.lames I. Johnson, and Z. V. Judd should constitute the board of health for
Wake County, their acceptance of said office would have rendered vacant the
office of chairman of the board of county commissioners, office of mayor of
Raleigh, and office of superintendent of public schools for Wake County. The
General Assembly seems to have linked the office of superintendent of the
board of health for Wake County with the other three offices and made them
inseparable, and for that reason, I think and hold that section 9 of Public Laws
of 1911, chapter G2, is unconstitutional and void."
It appears that the persons named above are respectively chairman of the
board of commissioners of Wake County, mayor of Raleigh, and county super-intendent
of schools for Wake County. Chapter 62, Laws of 1911, appears to
be a comprehensive revisal of all preceding laws. It covers the entire subject
of public health, both State and county. It first provides for the establish-ment
of a North Carolina Board of Health, which is to be made up by the
election by the Medical Society of North Carolina of four members, and by
appointment of the Governor of five. Section 9 constitutes the county board
of health of the chairman of the board of commissioners, the mayor of the
county town, and when there is no mayor, the clerk of the Superior Court, the
county superintendent of schools, together with two physicians to be elected
by those three public officials.
We are unable to concur in the conclusion that the statute is violative of
Article XIV, sec. 7, of our State Constitution. It is not a case where one
person holds two offices at the same time, but rather the case where the duties
of a member of the county board of health are to be performed ex officio by
the chairman of the board of commissioners, the mayor, and the superintendent
of schools-. These duties cannot be discharged by the individuals named in
his Honor's judgment any longer than during the period they hold the offices
of chairman, mayor and superintendent. The right to discharge such duties
is not conferred upon them as individuals, but is a part of the duties of the one
office already held by each.
The case of Barnhill v. Thompson, 122 N. C, 493, does not sustain the con-tention
of the defendants. The facts in that case show that the board of edu-cation
of Bladen County was elected by the board of commissioners of said
county, the clerk of the Superior Court and the register of deeds, under the
existing law, sitting with them. This body elected the defendant Thompson,
who was a member of the board of county commissioners, a member of the
board of education, and he undertook to exercise the duties of both offices.
This Court held that he was ineligible to discharge the duties of county com-missioner
; that when be accepted the second office he thereby vacated the one
he already hold. His right to act as a member of the board of education was
not questioned. In the case at bar the persons named in the judgment have
not been elected or appointed to any other office, but the added duties of the
county board of health have been placed upon the offices they already held, and
as long as they retain such offices they must discharge such duties, and when
they vacate such offices their successors must continue to perform them. By
discharging the duties of the board of health and acting as members of that
board those gentlemen did not vacate their offices they already held, for the
moment they resigned or vacated such offices they at once became ineligible to
continue as members of the board of health. For this reason they could have
BULLETIN N. C. BOARD OF HEALTH. 25
no right to elect which office they would take—the offices they held or member-ship
on the board of health. This legislation is not novel in North Carolina
—
nor, indeed, in the other States of the Union. In 1901 the Legislature passed
a similar act, section 4441 of the Revisal. That act provides that two physi-cians
shall be elected-—one by the chairman of the board of county commis-sioners,
and one by the mayor of the county town. who. together with the board
of commissioners, shall constitute the county sanitary committee, of which
committee the chairman of the board of county commissioners shall be ex
officio chairman.
We also have the familiar case of the Governor, who is made by law a
trustee of the University of the State and chairman of the board, and is
required to perform these duties and also act as chairman of the executive
committee of the trustees. Similar legislation is to be found in other States
having a constitutional provision similar to ours. In West Virginia the law
requires the Governor, Auditor, Treasurer, Superintendent of Schools, and
Attorney-General to serve on the board of public work, and prescibes the duties
of said board. The Court of Appeals, in an elaborate opinion, held the act valid.
saying, in substance, it simply prescribes additional powers and duties to be
performed by officers already elected by the people, and that it does not amount
to an appointment to an office created by law, but that it only amounts to
requiring the officers of the executive department elected by the people, to act as
members of the board of public works ; that it in substance simply annexes
additional powers and duties to their respective offices. The Court goes on
to say "that it is a time-honored usage in Virginia, and continued in West
Virginia, to cause certain duties which might have been assigned to officers
specially appointed or elected for the purpose, to be performed by officers
already appointed for general service." Bridges v. Shallcross, 6 W. Va., 57S.
citing Wales v. Belcher, 20 Mass., SOS. The question is considered, by the
Court of Appeals of Virginia in Sharpe v. Robertson, 5 Graft., 51S. In that
case certain duties were assigned the circuit judges to be performed in the
Court of Appeals and special compensation fixed by the General Assembly.
Judge Baldwin, speaking for the Court, says:
"But the act in question creates no new judicial offices and appoints no addi-tional
judges, but merely attaches new duties for offices existing to be per-formed
by the incumbents, within the constitutional power of the Legislature."
The subject is discussed by the Supreme Court of Texas in Powell v. Wilson.
16 Tex., p. 59, and the views we have expressed herein are fully supported.
The Court says : "It cannot be doubted that it is competent for the Legislature
to create an office, which shall be that of a substitute, or mere auxiliary to
another, the duties of which shall commence and consist in performing the
duties of the principal office." The subject is elaborately discussed by the
Supreme Court of Florida in Wilkins v. Conners, 27 Fla., 329, and it is held
that the statute making it the duty of the Sheriff of Escambia County to act as
city marshal of Pensacola is not obnoxious to the Constitution of that State,
declaring that "No person shall hold or perform the functions of more than
one office under the government of this State at the same time." In Louisiana
the same view is taken in State v. Somnie, 33 La. Ann., 237, where it is held
that the act providing that the clerk of the district court shall be ex officio
member of the jury commission does not confer an additional office upon the
incumbent of the clerk's office in violation of the constitutional restriction.
We could multiply authorities in support of these views, but deem it unnec-essary.
It is true, as contended, that section 9 uses this expression, "The term of
office of members of the county board of health shall terminate on the lirsi
Monday In January in the odd years of the calendar, and while on duty shall
receive $4 per diem, to be paid by the county." The former law declared their
term of office to be coterminus with that of the commissioners with whom they
serve, and when on duty they shall receive the same compensation as is
received by county commissioners. Evidently the language of the new act in
reference to term of office applies only to the two physicians who are chosen
as members of the county board of health by the chairman of the board of
county commissioners, by the mayor, and by the superintendent of schools.
26 BULLETIN N. C. BOARD OF HEALTH.
The change in the verbiage is due to the fact that there is a difference in the
terms of the ex officio members of the county board of health. The county
superintendent of schools goes out of office on the first Monday in July of each
year: the mayor of the county town, as a rule, goes out in May or June, while
the terms of the county commissioners expire in December. It evidently was
not intended to either leave a vacancy in the health board or to shorten or
lengthen the terms of the ex officio members. The person holding the office of
county commissioner when his successor is elected as chairman of the board
of county commissioners on the first Monday in December would go off the
county board of health and the succeeding chairman of the board of county
commissioners would co instanti become a member of the county board of
health. The same is true of the mayor and of the superintendent of public
schools.
Our conclusion being that the entire section of the act is a valid exercise of
legislative power, it is unnecessary to discuss the powers of the health board as
a de facto organization with a colorable right to discharge the duties imposed
upon it.
3. It is contended that the secretary of the State board did not fix the fees
as required by the act. We fail to see how this affects the plaintiff's title to
the office. It is plain that the secretary undertook to fix the fees to which
plaintiff would be entitled, but whether he observed the standard laid down by
the statute is not for us to determine in this proceeding. The statute, section
9. declares that the compensation of the superintendent of health for the
county, when fixed by said secretary, shall be "in proportion to the salaries
paid by other counties for the same service, having in view the amount of taxes
collected by said county."
And the same section declares that "all expenditures shall be approved by
the board of county commissioners before being paid."
It thus becomes the duty of the board of commissioners to pass on and audit
the plaintiff's accounts for services and to determine whether they are within
the bounds fixed by the statute. The approval of the defendant board is neces-sary
to the payment of plaintiff's account, and while the court will not under-take
to compel the county commissioners to approve them, it will require
them to consider the account and to pass on it in good faith in the exercise of
a sound judgment as to whether or not the services as charged are warranted
by the statute.
4. It is contended that mandamus is not the proper remedy, but that quo
warranto is. This contention is based upon the theory that one Dr. Stevens is
in possession of the office of "county superintendent of health" for Wake
County and exercising its functions. We find nothing in the record that gives
Dr. Stevens even a colorable title to the office or indicates that he is in pos-session
of it. The resolution of the county commissioners does not purport
to elect him superintendent of health or even to induct him into any office
established by law. If he is in the service of the county commissioners under
their resolution, a "county physician" (the term used in the resolution), then
he is merely a contract physician performing services which should be per-formed
by the plaintiff, and is not exercising the functions of a public office.
He has not even a colorable title to the office of "county superintendent of
health." He is not a party to this proceeding and was very properly omitted.
That mandamus is a proper remedy to enforce plaintiff's demands is estab-lished
by abundant authority. Moore v. Jones. 76 N. C. 1S5; Doyle v. Raleigh.
89 N. C. 133 ; Lyon v. Commissioners. 120 X. C. 239 ; Koonce v. Commissioners.
lOfi N. C. 192.
We assume that when this opinion is handed down it will be unnecessary for
plaintiff to sue out the writ; but in case it is. the plaintiff may apply for a
peremptory writ of mandamus to the judge of the Superior Court residing in
or holding the courts of the Sixth Judicial District.
The costs of this appeal will be paid by defendant board of commissioners.
Reversed.
BULLETIN N. C. BOARD OF HEALTH. 27
-McCULLERS CASE NOT ENDED.
County Attorney Beckwith Says Board Will Recognize Dr. McCullers, But
Appeals to the People for Final Judgment.
To the Editor of the Times: The board of commissioners for the
county of Wake is not resentful to criticism. It recognizes the preroga-tive
of the press to impeach and the right of the people to condemn any
official act of a public servant.
The Times having often exercised its high prerogative by impeaching
with vigor, though the people have not yet condemned, the board of com-missioners
for presuming to defend the supposed constitutional right of
the people to local self-government, and the right through their chosen
commissioners "to exercise a general supervision and control of the penal
and charitable institutions and finances of the county," will not, I pre-sume,
close its columns to this communication. I ask nothing but an
open field.
]^o doubt, the board of commissioners itself will not stand mute, when-ever
called upon by the people who elected them, to answer concerning
its action in questioning the legal right of a secretary of the State Board
of Health to foist upon a county an officer and fix his compensation with-out
the approval of the board of commissioners whose constitutional and
legal duty, it had been thought, was to have general supeiwision and con-trol
of the affairs, especially the financial affairs, of the county. And
I. as citizen and as attorney, shall not be silent whenever the inherent,
fundamental right of the people to local self-government is challenged
by any, on any pretext, or is taken away by act of Assembly under the
specious guise of protecting the public health.
But I shall not at this time trespass upon your space with long lists of
facts and figures, or fatigue your patience by a long string of reasons
for the board's action in defending the McCullers case, but shall be as
brief and pointed as possible. Enough to say, they held it to be their
sworn duty.
On the second Monday in May, 1911, the county board of health (a
new creation by the last Legislature), composed of the mayor of the
county town, the county superintendent of schools, the chairman of the
board of county commissioners, and two physicians chosen by them, met
and elected Dr. J. J. L. McCullers to the position of county superintend-ent
of health, a new office created by chapter 62, Public Laws 1911.
At the regular monthly meeting of the board of county commissioners,
June 7, 1911, the members of the county board of health, together with
a number of individual citizens, appeared before the board of commis-sioners
and requested approval by the board of a proposed salary of
twenty-five hundred dollars ($2,500) a year to be paid Dr. McCullers as
county superintendent of health, out of the general county fund.
Having listened to arguments by the visitors and having given the
matter due consideration, the county commissioners did not feel justified
in approving of $2,500 to be paid out of the county treasury to a superin-tendent
of health, as the board knew that the proposed salary was greatly
in excess of that for which identical service could be obtained; so the
board passed a resolution directing the payment, out of the general fund
*Raleigh Evening Times, February 29, 1912.
28 BULLETIN N. C. BOARD OF HEALTH.
of the county, of the sum of six hundred dollars ($600) a year as com-pensation
or salary to the county superintendent of health, providing he
discharged certain duties therein specified, and deducting so much from
said salary for his negligently failing to perform the same.
Although Dr. MeCullers had been an active candidate for reelection
to the office of county superintendent of health or county physician at a
salary of $50 a month (the salary he had received during former terms
in that office) prior to the passage of said chapter 62, yet after the pas-sage,
on March 7, 1911, of that act (which seemed to open wide the doors
of the county treasury) and after the board of county commissioners had
withheld its approval of the $2,500 salary proposition, submitted by the
county board of' health, Dr.' MeCullers refused to qualify by not taking
the oaths of office, thereby creating a vacancy in the office of county
superintendent of health.
Instead of proceeding to fill the vacancy by electing another, as was
their duty, under the law, the county board of health on the .... day of
July, 1911, sixty days after Dr. MeCullers' declination had been received,
met and passed a resolution humbly petitioning Dr. W. S. Kankin, secre-tary
of the State Board of Health, to appoint a county superintendent
of health for Wake County, kindly suggesting therein Dr. MeCullers as
a fit person for the job.
Dr. Kankin graciously consenting, on the 17th of July, 1911, wrote
Dr. MeCullers of his appointment, having favorably considered the
prayers of the county board of health in his behalf, and fixing his com-pensation
by a schedule of fees—on a very remunerative basis indeed
—
although he was advised that to fix the compensation of a county super-intendent
of health on a fee basis, for this county, would be to fly in the
face of the legally established policy of Wake County against the fee
system of paying county officers. But who cared for that ? In the words
of a Vanderbilt, "The people be damned" with their policy
!
The board of commissioners being advised that Dr. Rankin's appoint-ment
of Dr. MeCullers was ultra vires and void, and that his compensa-tion
under the schedule of fees fixed by the secretary of the State Board
of Health was grossly excessive, unjust to the county, and contrary to
law, refused to recognize Dr. MeCullers as county superintendent of
health on a fee basis, and withheld approval of his bills—one of which
amounted to $89.50 for eleven days ordinary professional service. Upon
this as a basis of calculation, Dr. MeCullers' fees as county superin-tendent
of health would exceed $3,000 a year; and as like seiwiee could
be had of other skilled physicians for $600 a year, or $50 a month, the
county commissioners could not feel justified in approving bills based
upon a schedule of fees so unjust to the county.
On the 2d day of November, 1911, Dr. MeCullers brought his action
against the board of commissioners, demanding a writ of mandamus
compelling the board of commissioners to recognize his appointment as
county superintendent of health, and directing said board to audit and
approve his bills. The board of commissioners, answering his complaint,
among other things, alleged that section 9 of chapter 62, Public Laws
1911, was unconstitutional and void; that the secretary of the State
Board of Health had not authority to appoint ; that the compensation
arising out of said schedule of fees as fixed by Dr. Kankin was grossly
BULLETIN N. C. BOARD OF HEALTH. 29
excessive in that it would amount to more than $3,000 a year ; that man-damus
would not lie to compel "approval"; that Dr. W. S. Stevens, a
skilled physician, was filling said office and performing the duties thereof
for the sum of $50 a month, and moved the court to dismiss the action.
The Superior Court sustained the contentions of the board of commis-sioners
and rendered judgment dismissing the plaintiff's action. From
that judgment Dr. McCullers appealed to the Supreme Court. By an
opinion recently handed down (and published in full in The Times,
with editorial comment not complimentary to the board of commis-sioners),
the Supreme Court reversed the judgment of the court below,
holding that section 9 of said chapter 62 was constitutional; that Dr.
Rankin had authority to appoint, and that Dr. McCullers was entitled
to the office. But the Court also held that Dr. McCullers' compensation
must be passed upon and approved by the board of county commissioners
before being paid, leaving the amount of the same to be determined in
the sound discretion of the board of commissioners, under the law, what-ever
that may mean.
Being law-abiding citizens, the board of commissioners, in obedience
to the opinion of the Supreme Court, will of course recognize Dr. McCul-lers'
title to the office. But from that opinion they appeal to Caesar—to
the people themselves. I submit for their verdict and final judgment,
the following issues
:
1. Shall an act, such as section 9 of chapter 62, Public Laws 1911, as
construed and held to be, depriving the people of the inherent right of
local self-government, taking from them their control of local domestic
affairs, remain on the statute books?
2. Shall the constitutional right of the people, exercised through their
chosen boards of commissioners, to general control and supervision of
the penal and charitable institutions and finances of the county be trans-ferred
from their hands into and remain in the hands of one man—
a
secretary of a State board—not elected by or answerable to the people ?
3. Shall the ultimate power of appointing to a vacancy in a county
office be and remain lodged in the hands of a secretary of a State board,
and shall the salary or fees to be paid a county officer out of the county's
general fund depend upon a schedule of fees fixed by or be measured by
a standard created by the whim or prejudice or at the arbitrary will of
a secretary of a board not elected by or answerable to the people ?
4. If in their opinion it be contrary to the public interest, shall the
board of commissioners be compellable to approve and pay bills for
fees, that may aggregate $3,000 and more a year, to a county physician
not elected by them or the people, for professional services, when like
service can be had from another equally skilled, for $600 a year? And
if so, why?
5. Shall the people demand of their representatives in the General
Assembly a pledge to restore to the counties control of their local domes-tic
affairs by repealing or amending cliapter 62, Public Laws 10 1 1 '.
Upon these issues, of far more vital interesl to the people of Wake
County than which one of the four distinguished candidates slinll be
United States Senator, as involving preconstitutional, inherent rights of
the people to local self-government, I shall be beard, in due season, in
the forum of the people. B. C. Beck with.
30 BULLETIN N. C. BOARD OF HEALTH.
*DR. RANKIN ON THE SITUATION.
SECRETARY OF STATE BOARD OF HEALTH REPLIES TO COUNTY
ATTORNEY—THINGS POINTED OUT.
Dr. Rankin Shows Why it is Duty of State, When County Refuses to Provide
Protection, to Step in and Take Care of Whole People—Basis for Remu-neration
$1,200 or $1,500 a Year, and not $3,000, as Claimed by County
Attorney and Commissioners—Interesting Communication.
To the Editor of The Times: Your paper under date of February 29
contains an article from Mr. B. C. Beckwith, attorney for Wake County,
and, presumably, spokesman for the Wake County Commissioners, to
which a reply from the secretary of the State Board of Health may not
be altogether out of order.
SUM AND SUBSTANCE OF MR. BEOKWITh's ARTICLE.
A fair, unbiased mind, on carefully reading the aforesaid article with
its five conclusions, stated as issues, can reduce all that Mr. Beckwitk
claims to two and only two contentions
:
First, that section 9, chapter 62, Public Laws of 1911, under the com-mand
of which the secretary of the State Board of Health acted in
appointing Dr. J. J. L. McCullers county superintendent of health of
Wake County, is in violation of that which all good citizens prize as
their most fundamental right—local self-government ; second, that the
basis of remuneration for the services of the county superintendent of
health of Wake County, as fixed by the aforesaid secretary, is wrong in
principle and excessive in amount.
We deny both of these contentions, and respectfully submit the follow-ing
facts and conclusions in support of our position
:
STATE HEALTH LAW AND LOCAL SELF-GOVERNMENT NOT INCOMPATIBLE.
This is best brought out by an examination of the provisions of sec-tion
9, under which Mr. Beckwith contends the State Board of Health
is given authority that interferes with local self-government. Section 9
is as follows
:
The chairman of the board of county commissioners, the mayor of the
county town, and in county towns where there is no mayor, the clerk of the
Superior Court, and the county superintendent of schools shall meet together
on the first Monday in April, one thousand nine hundred and eleven, and there-after
on the first Monday in January in the odd years of the calendar, and
elect from the regularly registered physicians of the county, two physicians,
who, with themselves, shall constitute the county board of health. The chair-man
of the board of county commissioners shall be chairman of the county
board of healtb. and the presence of three members at any regular or called
meeting shall constitute a quorum. The term of office of members of the
county board of health shall terminate on the first Monday in January in the
odd years of the calendar, and while on duty they shall receive four dollars
per diem, to be paid by the county. The county board of health shall have
the immediate care and responsibility of the health interests of their county.
They shall meet annually in the county town, and three members of the board
are authorized to call a meeting of the board whenever in their opinion the
*Raleigh Evening Times, March 4, 1912.
BULLETIN N". C. BOARD OF HEALTH. 31
public health interests of the county require it. They shall make such rules
and regulations, pay such fees and salary, and impose such penalties as in their
judgment may be necessary to protect and advance the public health : Pro-vided,
that all expenditures shall be approved by the board of county commis-sioners
before being paid. At their first annual meeting on the second Monday
of May, one thousand nine hundred and eleven, and thereafter on the second
Monday of January in the odd years of the calendar, they shall elect the
county superintendent of health, who shall serve thereafter until the second
Monday in January of the odd years of the calendar: Provided, that if the
county board of health of any county shall fail to elect a county superintendent
of health within two calendar months of the time set in this section, the secre-tary
of the State Board of Health shall appoint a registered physician of good
standing in the said county, who shall serve the remainder of the two years,
and shall fix his compensation, to be paid by the said county, in proportion to
the salaries paid by other counties for the same service, having in view the
amount of taxes collected by said county.
This section, be it observed, places the care of the public health of the
county in the hands of a board composed of men who, in a county where
there are several political factions, would represent, in all probability,
no one faction, and of men who, judging from their official positions,
have the ability to appreciate their important responsibilities in connec-tion
with the public health. In other words, the county board of health
is, as near as it is possible to make it, a body free from politics, it being
recognized by the General Assembly, and all others who properly appre-ciate
the importance of the public health, that the health and life of the
people should not be used as an asset of politicians wuth which to pay
off their political obligations.
In this county the board of health is composed of Hon. D. T. Johnson,
chairman, board of county commissioners; Hon. J. I. Johnson, mayor,
city of Ealeigh; Mr. Z. V. Judd, Dr. Henry Mclvee Tucker, and
Dr. G. M. Bell. I respectfully submit that this body compares favorably
in ability and in devotion to the people's interest with the Wake County
Board of Commissioners, or even with their learned legal adviser, so
zealous in the protection of the people's interest.
Be it observed that under the law the county authorities have two
months in which to provide an official whose duties are literally vital to
the welfare of the public. Failing in this ample time to discharge this
important function of their office, the State steps in, overrides official
inertia or breaks a deadlock and gives the county a legally responsible
official with authority to protect the health and lives of the people. And
this is what Mr. Beckwith terms an interference with local self-govern-ment.
But why, if the accredited representatives of the people of a county
really desire no legally responsible health officer clothed with the power
of a sovereign State to enforce the laws that stand between pestilence and
life, should the State insist upon their having one? Is such a condition
not their own affair? Xo, and no ever since the Judge of judges declared
that "no man liveth unto himself." No, because natural laws enacted
by the Legislator who never erred, and which are not subject to repeal
by a board of county commissioners, enforce the afore-quoted principle
of life through the agency of infection—an agency that respects no
county boundary, an agency more active as our civilization grows in
complexity and the facilities of travel are improved, an agency, operative
32 BULLETIN N. C. BOARD OF HEALTH.
through bonds of common suffering and sympathy, that is drawing the
great human family into a more mutually dependent, powerfully cooper-ative
organic whole. To conclude our reply to Mr. Beckwith's first con-tention
: Those who admit the operations of those divine or natural laws
which we have just referred to must concede that the State owes to her
confederate counties protection from any county which, for any reason,
fails after the lapse of a reasonable time to provide an official who can
be held legally responsible for disease-disseminating nuisances and epi-demics
that endanger, disable, and kill the citizens of neighboring and
even distant counties.
THE SYSTEM OF REMUNERATION FOR COUNTY HEALTH WORK.
There are two ways to render a bill or account : one in the form of a
lump sum "for services rendered," in which the particular services ren-dered,
the items, are unstated and unknown; the other, in the form of an
itemized statement in which each particular service rendered, with the
amount charged for it, is so stated as to be subject to public investigation,
and if necessary, criticism. To fair-minded people we respectfully sub-mit
'that where there is likelihood of a controversy over an account, it is
safer and wiser to have the account submitted item by item. The public
can then see exactly what they are paying for each service and criticism
may be specific, to the point. Recognizing the likelihood of a contro-versy
we declined the advice of friends and deliberately authorized a
basis for remunerating the county health officer so that he would be paid
only for what he did and so that the amount paid for each item of
service could be seen by any one interested. So much for the "fee sys-tem"
; and now a few words in regard to
THE AMOUNT OF REMUNERATION.
The law requires the secretary of the State Board of Health to fix the
compensation of a county health officer, appointed by him, in accordance
with salaries paid by other counties of equal wealth for such service.
Now let us see how Wake County compares m wealth with other
counties, and what some of the other counties are paying their health
officers
' Wake is the second county in population, second in size, and
fourth in wealth of the counties of North Carolina. The salary of $600
a year which the commissioners wanted to pay their health officer would
place Wake seventeenth in the list of counties in the total salary paid
the health officer, or, if we look at the amount paid the officer from a
per capita standpoint, Wake would be forty-fifth among the counties
The schedule of fees fixed as the basis of remuneration for the health
officer of Wake County will aggregate in a year about $1,200 to $1,500,
and not $3,000, as claimed by Mr. Beckwith. The eleven days service
for which a bill of $89.50 was rendered were the last eleven days of the
month when Dr. McCullers took charge of the work. All of the county
institutions had to be inspected in that time, and there was in all proba-bility
an unusual amount of sickness among the wards of the county at
the time. Now that Dr. McCullers is to be officially recognized, we con-fidently
leave to the next two or three months the refutation of Mr.
Beckwith's claim that the health officer's compensation will aggregate
$3 000 a year. It will not exceed $1,500 a year, and we believe that, it
BULLETIN N. C. BOARD OF HEALTH. 33
that provision of the law which permits the county health officer to save
mileage to the county by employing the nearest regular physician to a
convict camp or county home to attend a sick inmate is duly regarded
by the health officer, the amount paid for this work will not exceed $1 ,200
a year. "We fixed the compensation of the health officer just as the law
prescribes, that is, in accordance with the compensation of health officers
in other counties of the State of like wealth to Wake.
But Mr. Beckwith says that a skilled physician could be obtained for
$600 a year, and he leaves the inference that all in excess of that amount
paid the county health officer is gross extravagance. Was the skilled
physician employed the cheapest available? What county offices or State
offices could not be filled by cheaper men than their present occupants?
And some of the cheaper men would be just as efficient officials as a few
now in office. Even the office of Wake County attorney might be let to
a cheaper man, and one, too, who would not put his county to an expense
which will exceed the cost of an entire year's health work by contesting
in the courts the constitutionality of an act that the Supreme Court
unanimously upheld.
The laws affecting officeholding do not recognize the lowest salary for
which officials may be obtained as the best salary to attach to an office.
An equitable compensation sufficient to secure the application of muni/
good men gives the electors the privilege of exercising some choice in the
selection of officials. A salary so small as to restrict the electors to only
a few men in filling important offices is detrimental to the public welfare.
For fifteen years the salary of the health officer of Wake County has
ranged between $500 and $600 a year. During this time the population
has increased 20 per cent, the wealth 40 per cent, new duties have been
added to the health office, and science has multiplied the opportunities
and increased the responsibility of these officials. With a salary of only
$600 a year for the health officer, the choice of the people must become
more restricted as the county develops.
Wake should be in the same class with Guilford, Kobeson, Durham,
and JNTew Hanover, where health officers are employed at salaries of from
$1,800 to $2,500 and give their entire time to their work. Certainly we
should not pay less than $1,200 a year, which will permit the health
official to not only visit the sick in county institutions, but to do thai
which is far more important, carry on an aggressive campaign of disease
prevention.
The choice of a health officer was left entirely with the authorities
whom the law appoints to make this selection. The county board of
health recommended Dr. J. J. L. Meddlers for the place, and recog-nizing
the fundamental principle of local self-government, he was
appointed by the writer. It was after the recommendations of the county
board of health had been acted upon by the State Board of Health that
the commissioners went out, sought, and obtained a physician who a
to do certain of the county public health work for $600 a yen-.
We repeat that, any vacancy in county offices filled by appointment at
an equitable salary could be criticised on the ground that after the office
was so filled, another person could be found who would agree to accept
the office for a smaller remuneration. W. S. Rankin,
Secretary State Board of 11 alth.
34 BULLETIN N. C. BOARD OF HEALTH.
*MR. BECKWITH COMES AGAIN.
REPLIES TO DR. RANKIN IN THE COUNTY SUPERINTENDENT OF
HEALTH MATTER—QUESTION OF RIGHTS.
Issue Not One of Men, But of Rights Older Than the Constitution—County
Commissioners Abide by the Law as Interpreted, But They Have an Abid-ing
Faith that the Rights of the People to Manage Their Own Affairs Shall
Not Be Permanently Abridged—Not Afraid of a Writ of Mandamus.
To the Editor of The Times: In an editorial commenting on the
county attorney's communication in the McCullers case, you said he
"missed the point." Maybe so. But in shelling the woods he (the
county attorney) unmasked and drew the fire of a heavy battery support-ing
the line of attack against the rights of the people of Wake County
to govern themselves and to attend to their own local affairs.
But, unless the unmasking of the Doctor's battery riled him, there was
and is no cause for a rise of temperature in the office of the secretary of
the State Board of Health; for "I am not mad, most noble Festus; but
speak forth the words of truth and soberness"—appealing to Csesar,
that the people may know the inwards of this matter.
The vital issue in the McCullers matter shall not be clouded by hot
vapors blown into the face of the county attorney, or obscured by dust
flung at the heads of the county commissioners.
The issue is not men, but measures. And it is the iniquitous measures
contained in the "health act," that the secretary of the State Board of
Health boasts were unanimously upheld by the Supreme Court, to
which the people felt constrained to hold that the enactment of chapter
62 of the Public Laws of 1911 "was a valid exercise of legislative power"
;
the Court did not hold that it was a just exercise of that power.
With all due deference that a lawyer owes the opinions of that high
Court, that act, as interpreted, deprives the people of Wake County of
their inalienable right of local self-government, and in great measure
takes away their constitutional control of the penal and charitable insti-tutions
of the county, and ought to be, if it is not, unconstitutional and
void as contravening the spirit of local self-government which underlies
the Constitution and is inherent in the people, for the people did not
surrender that right when they adopted the Constitution.
That act, as interpreted, places in the hands of an "Outlander" secre-tary
of a State board the ultimate power of appointing and fixing in fees
the compensation of a county officer, who has superior control of large
interests of the county, and that too without consulting the wishes of the
people as to their choice and contrary to the legally established policy of
the county against the vicious and corrupt fee-system county officers.
Let us see if it does not, by quoting here from the act itself : "Pro-vided,
that if the county board of health of any county shall fail to elect
*Raleigh Evening Times, March 9, 1912.
BULLETIN N. C. BOARD OF HEALTH. 35
a county superintendent within two months of the time set in this action
[which the county board of health, for causes best known to themselves,
promptly proceeded to 'fail' to do], the secretary of the State Board of
Health shall appoint a county superintendent of health, and fix his com-pensation
to be paid by the county"-—both of which powers the said
secretary of the State Board of Health very promptly exercised without
consulting the county commissioners, the ones most interested, although
they, through their chairman, asked to be considered as being interested
for the county in both the officer and his pay. The choice of the secre-tary
fell upon that one whom the county board of health, having failed
to reelect, humbly petitioned the secretary of the State Board of Health
to appoint. Of course
!
The county board of health having authority under the act to fill the
vacancy occasioned by Dr. McCullers' declination to qualify upon the
May election, and after the board of commissioners had recognized his
title to the office under that election, but had declined the proposition of
the county board of health to approve a salary of $2,500 to be paid by
the county, but had approved of a salary of $600 a year—a just and rea-sonable
compensation for the work to be done—the questions naturally
arise: Why didn't they reelect Dr. McCullers? or why their delay for
two months in electing another, till Dr. Rankin's power of appointing
attached and became operative? and why humbly petition, as to a supe-rior,
Dr. Rankin to appoint Dr. McCullers, and to fix his fees after Mc-
Cullers had eliminated himself by declining their May election ?
'Tis here the people smell the nigger in the woodpile, and ask: Hoav
cum ?
Was the county board of health fearful of the people's disapproval of
its choice? Was the salary or fees demanded by their chosen one more
than they thought the people would stomach? Or, fearing to face
the people with their choice and his bills for fees, did they deliberately
shield themselves from wrath to come behind the secretary of the Slate
Board of Health, who does not owe his lucrative office to the favor of the
people, and cannot be called to account by them for appointing a man
to office and fixing his compensation on a condemned fee basis and on
an excessive amount, many times greater than the $600 a year salary
that others, just as good, were willing to accept as compensation for
their services ?
That high-handed invasion of and disregard of their constitutional
rights forced the commissioners to call a halt and to defend the suit
brought against the board of commissioners by Dr. McCullers. 'The
commissioners did not seek to begin the fight. They have acted in self-defense,
in the interest of the county.
But the secretary of the State Board of Health says: "I respectfully
submit that this body (meaning the county board of health) compares
favorably in ability and devotion to the people's interests with the
Wake County Board of Commissioners, or even with their learned legal
adviser, so zealous in the protection of the people's interests."
Why throw that handful of dust? Who has questioned their ability
or devotion? Let it be granted that they excel in these virtues; yr\ if
36 BULLETIN N. C. BOAED OF HEALTH.
the acts and the words of the secretary of the State Board of Health he
taken, the fact remains that they failed to discharge a legal official duty,
thereby shifting their sacred responsibility for the health of the people to
the hands of the secretary of the State Board of Health, who (and what
more could he said) condemns them after this fashion: "Be it observed,
that under the law the county authorities (meaning the county board
of health ) have two months in which to provide an official whose duties
are literally vital to the welfare of the public; failing in this ample time
to discharge this important function of their office, the State steps in,
overrides official inertia or breaks a deadlock, and gives the county a
legally responsible official with authority to protect the health and lives
of the people. And this is what Mr. Beckwith terms an interference
with local self-government."
And Mr. Beckwith is correct; for by contrived negligence, procured
concert of action, political cowardice or combination or fear of responsi-bility,
the ultimate choice of a county health officer in every county and
the fixing of his salary or fees is put into the hands of a mere secretary
of a State board, and the people are thus deprived of selecting their own
officer or of fixing his pay. But they have the inestimable privilege
and pleasure of paying the bills.
And with this privilege left them by this "health act," the people
ought to be content. Are not their backs broad? Surely they ought to
be glad to pay fee- that will enable their county doctor to ride to this
camp and from that institution in style befitting the appointee of the
secretary of a State board !
The secretary of the State Board of Health, in his four-column com-munication,
quoted a part of section 9 of the "health act." But he did
not quote the following pregnant proviso :
"Provided, that the county superintendent of health shall have the right to
employ and to lix the compensation of any other regularly registered physician
of his county, to perforin any or all of the duties pertaining to the jail, county
home, or convict camps when in his judgment it is desirable to do so."
Bead that over, and read it yet again, and then go back and gently
and prayerfully, if you can, glide through that provision, word by
word, and then wonder at the sublime patience of boards of county com-missioners.
In the words of the immortal Vance, "My God, Aber-nathy
!" Here we have the appointee of an appointee (neither of whom
is answerable to the people) given discretionary power to appoint yet
another officer and to fix his fees without limit to anything. And yet
the county commissioners pay a fee salary of $2,500 or more—plus
whatever the county superintendent of health may see fit "to fix" for
that other doctor, and be glad it's no worse, or go to jail.
They boast that the Supreme Court has upheld the validity of their
act and gloat over what they allege is the failure of the board of com-missioners
to place a barrier between these appointees and the treasury
of the people, and threaten with a peremptory bill of mandamus, and
thus, by implication, with the jail, the commissioners of the people if
they dare refuse approval of their bills.
BULLETIN N. C. BOARD OF HEALTH. 37
To their interpretation of their act and of the opinion of the court the
board of county commissioners has not yielded and will not assent, if
they follow the advice of the county attorney, till such time as they shall
have exhausted every legal means of resistance at their command.
We believe the people of Wake are willing that their chosen commis-sioners
should spend the public money in defending the people's right
to choose their own local servants, fix their pay, and manage their own
domestic affairs. They would justly condemn their servants for failure
to defend to the uttermost any attack on the right of the board of com-missioners
to watch over and safeguard the county treasury against
spoliation, even under the specious guise of protecting the public health.
Now, the county attorney has no personal quarrel with any. The
issue is far above mere persons. It involves rights older than our Con-stitution—
that were hoary with age before the Boston tea party; rights
fought for and won back by ville and town and Mark from King, and
baron, and abbot, who had with iron hand or lying tongue, by force or
fraud, taken them from the people; rights that our forefathers, even
here, thought worthy of being maintained with treasures and blood at
Alamance, at Moore's Creek, at Guilford Courthouse, at Kings Moun-tain,
and made good at Yorktown—the right of local self-government
and the control by the people of their own money.
The extortions of the fee system (again attempted to be fixed on us by
this secretary) of paying officials was one of the main grievances that-led
to the regulator troubles of our fathers.
The board of county commissioners while bowing to this act (for law
it is, though of questionable parentage) as interpreted by the Supreme
Court, in recognizing Dr. McCullers' title to office, still have an abiding
faith that soon again the constitutional "right of the people of the
county to manage their own affairs shall not be abridged or denied
except under the pressure of a plain and positive requirement and when
no alternative in the law is admissible." We devoutly pray that the
court may soon return to the sound law of that opinion. And in the
words of a learned associate justice of our Supreme Court, used in Jones
v. Commissioners, 135 N". C, 223, we pray it may soon again be held
to be "without precedent in this State, if the Legislature should assume
to know the wishes and interests of the people of any county better than
the county commissioners." In this case, it is not the Legislature only,
but a board of health and a secretary of a State board who has assumed
to know the wishes and interest of the people of Wake County belter
than the county commissioners, the duly elected servants of the people
and answerable to them for the proper management of the affairs of the
county.
In conclusion, I want to say that I assume full responsibility for hav-ing
the board of commissioners not to recognize the authority of the
secretary of the State Board of Health to appoint a county superin-tendent
of health and to fix his compensation on a fee basis, to be paid
by the county, contrary to the legally established policy of this county,
till they were compelled to do so, by the order the Supreme Court. 1
also have advised them not to surrender, without a fight to a finish, the
38 BULLETIN N. C. BOARD OF HEALTH.
theretofore supposed right of the hoard of commissioners in its sound